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Please answer the questions
below based on your experiences with Sims Consulting
& Clinical Services
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Demographic Information
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Gender
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Person completing
the form is:
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Race:
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I was able to get a routine
appointment in a timely manner.
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I have never had to wait more
than 15 minutes past my appointment.
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I am able to call during office
hours and get the help or advice that I need.
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The Provider listens carefully
to my needs.
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The Provider speaks and explains
things in a way that I can understand.
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The Provider shows respect for
what I have to say.
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The Provider spends an appropriate
amount of time with me.
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Office staff treated me with
courtesy and respect.
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Office staff was very helpful
to me and my family.
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Provider is very knowledgeable
of my specific condition/needs
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If a friend asked, I would recommend
this provider/agency.
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Overall I am satisfied and feel
comfortable with this Provider.
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Due to this Provider, I have
a better quality of life
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Please list any strengths the
provider/agency demonstrates:
Please list any weaknesses the provider/agency has:
Please list any other information you would like to
share in the comments section below:
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If you would like our Quality
Management Department to call you about this survey
please give us the information below:
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