Norman Endoscopy Center Patient Evaluation

You deserve the best medical care available. We hope that you are satisfied with the care that you received while at our facility. Please take the time to answer the questions below and return the survey to us. Your suggestions for improvement are most welcome. Also, feel free to recognize any employee who made your visit more comfortable.

This survey is for feedback following your endoscopy procedure only. Please do not leave messages to change or cancel an appointment or for the office to call you back.

Thank you for your assistance.

Your Name (not required): Your Address, City, State & Zip (not required): Your Email (required): Physician (required): Date of Service (required): Please Rate the Following on a scale of 1-10: (10 strongly agree, 1 strongly disagree, 0 is not applicable and will be left blank) I was given adequate, relevant, useful info about fees, insurance and billing policies: The staff that called me at home to pre-registered me for my procedure was considerate, friendly, and knowledgeable: I received a call the business day before my procedure and staff reminded me of my procedure day and scheduled time of arrival: Nursing staff was considerate, friendly, and knowledgeable: Staff at reception desk was considerate, friendly, and knowledgeable during my check-in process: The staff's instructions concerning my discharge were explained to my driver. The written discharge instructions were clear and easy to understand: My physician spoke with me before my procedure. He answered my questions: I am likely to return to this Center for care and/or recommend this center to others: Prove you are human (required): Additional Comments: Disregard This: