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Satisfaction Survey

By filling out this brief satisfaction survey you can help us to serve you better. Any information you submit will be kept strictly confidential.


How did you hear of us?
Doctor referral from:
A friend or relative
A staff member of hospital or another doctor's office
The internet (web)

For how long have you been a patient?
I'm not yet a patient
Less than 6 months
Less than 1 year
1 year or more

Which provider did you see?
Dr. Gentry
Dr. Chan
Reena Cho, N.P.

Please score us on the following aspects of our practice:

Were we able to schedule an appointment for you within a reasonable time?
Poor Fair Good Very Good Excellent

At your appointment, did the doctor see you within a reasonable time?
Poor Fair Good Very Good Excellent

Were the staff pleasant?
Poor Fair Good Very Good Excellent

Were the staff professional?
Poor Fair Good Very Good Excellent

Was the doctor pleasant?
Poor Fair Good Very Good Excellent

Was the doctor professional?
Poor Fair Good Very Good Excellent

Did you feel that the doctor listened to your needs?
Poor Fair Good Very Good Excellent

Were your questions answered to your satisfaction?
Poor Fair Good Very Good Excellent

Did the doctor explain procedures and diagnoses to your satisfaction?
Poor Fair Good Very Good Excellent

Was the exam room clean and pleasant?
Poor Fair Good Very Good Excellent

Did the doctor spend enough time with you?
Poor Fair Good Very Good Excellent

Was the receptionist pleasant and helpful?
Poor Fair Good Very Good Excellent

Were staff professional on the telephone?
Poor Fair Good Very Good Excellent

Were staff pleasant on the telephone?
Poor Fair Good Very Good Excellent

Was the medical assistant pleasant and helpful?
Poor Fair Good Very Good Excellent

Was the waiting room pleasant and comfortable?
Poor Fair Good Very Good Excellent

Were you able to find parking?
Poor Fair Good Very Good Excellent

Was your spouse/partner/friend comfortable in our office?
Poor Fair Good Very Good Excellent

Overall, how satisfied were you with our office?
Poor Fair Good Very Good Excellent

Would you recommend East Bay Women's Health to your friends or family members?
No Possibly Probably Definitely

Have we cared for you during a pregnancy?
Yes No

If so, was your doctor present at your delivery?
Yes No

What improvements would you like to see in our office?

What factor do you feel is most important in your satisfaction when visiting our office?

Is there any thing that you specially like about your experience in our office?

If you have any special concerns about your experience in our office that you would like to discuss with one of the doctors, please list them here. Include your name and phone number if you would like the doctor to contact you.

Your name (optional):

Your email (optional):

Thank you very much for participating in our survey.

Comments about this site? Please email our webmaster.
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East Bay Women's Health
3300 Webster Street, Suite 1200
Oakland, CA 94609
(510) 653-0846