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General Health and Wellness
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Patient Satisfaction Survey
At Trinity Medical Group, we are committed to constantly evaluating and improving our care. In an effort to do this, we ask that you take a few moments to provide your feedback through the form below. Thank you in advance for your time and trusting us with your medical care.
Name
*
First
Last
Email address
*
How did you hear about our office?
Which clinic location did you visit?
Lakeland
Winter Haven
Have you been to our office before?
Yes
No
How long did you wait before you were seen by a doctor?
Less than 30 Minutes
30 Minutes - 1 Hour
More than 1 Hour
Did you feel the amount of time you had to wait before being seen by a doctor was reasonable?
Yes
No
Which provider did you see during your visit?
Is this the provider you usually see if you need a physical exam, have a health problem, or get sick or hurt?
Yes
No
Were you pleased with the courtesy you were shown by staff at the office?
Yes, very pleased.
Somewhat pleased.
No, not pleased.
Were you satisfied with the availability of appointment times?
Yes
No
What did you like most about your visit today?
Is there anything we can do to make future visits better for you?
Would you recommend our office to family and friends?
Yes
No
How satisfied were you with the level of attention given by the doctor?
Very Satisfied
Somewhat Satisfied
Undecided
Somewhat Dissatisfied
Very Dissatisfied
Overall, how would you rate your visit to our office?
Very Satisfied
Somewhat Satisfied
Undecided
Somewhat Dissatisfied
Very Dissatisfied
About Us
Our Providers
Services
▼
General Health and Wellness
Acute Conditions
Chronic Conditions
Women’s Health
Weight Management
Hormone Replacement Pellet Therapy
Insurance Information
Patient Resources
▲
Common Questions
Request An Appointment
Patient Forms
Patient Rights
Patient Satisfaction Survey
Workers’ Comp
Contact Us
Events
