Berks Cardiologists, Ltd.

Visit our second location at 1816 West Market Street, Pottsville, PA

Patient Satisfaction Survey

In an ongoing effort to improve patients’ experiences with our office, we would greatly appreciate if you would take a few moments to answer the following questions on this survey form. Please select the best answer to each question.

Thank you for taking the time to help us deliver a high level of service to all of our patients!

Your Name (optional)

Your Email (required)

Physician's Name (required)

Date of Visit

1. Would you refer a friend to Berks Cardiologists?

2. Ease in scheduling appointment:

3. Welcome by Receptionist:

4. Check in Process:

5. Appearance of the reception staff:

6. Office Staff's help with your insurance paperwork:

7. Waiting time in lobby:

8. Literature/reading materials in lobby:

9. Adequacy of parking:

10. Cleanliness in surroundings:

11. Friendliness and helpfulness of nursing staff during your visit:

12. Availability of literature regarding your condition or illness:

13. Friendliness of the physician:

14. Physician's concern for you:

15. Physician's thoroughness:

16. Physician's answers to your questions:

17. Quality of information given by the clinical staff:

18. Financial policies, arrangements, or payment plans:

19. Check out process is smooth and efficient:

20. Overall, how satisfied or dissatisfied you are with our services?

Additional Comments