Clinic Satisfaction Survey Name Thank you for giving us the opportunity to serve you better. Please take a few minutes to tell us about your experience. Interaction with Clinic staff was friendly and professional? * Yes No Did your provider supply helpful information and listen to your concerns? * Yes No Would you be interested in receiving appointment reminders by text message? * Yes No Was your wait time to see your provider reasonable? * Yes No Based on your experience, will you continue using services here at the clinic? * Very Likely Somewhat Likely Not Very Likely Not Likely Please rate your satisfaction with the following aspects of our services: Contacting clinic on phone * Ability to get appointment * Quality of care by provider * Overall experience * Name (Optional) Date of Visit * Any additional comments? If you have any concerns don't hesitate to contact our Tribal Health Director, Janet Mullen, RN, BSN at 907-567-3370 Option #4, or firstname.lastname@example.org.