Satisfaction Survey | Unity Health Network

Your responses are vital in helping us understand your needs as well as ways we can improve or even change our services to set an even higher standard of patient care. We welcome your opinions and suggestions so we can make your next experience with us an even more efficient and satisfying one. Please keep in mind that, not only are you letting us know how our service was for you, but you are helping us improve the quality of our care for every patient we see.

This survey has been updated to reflect that patients are receiving health care in person, by phone, and by video. The questions in this survey will refer to the provider named in Question 1 as “this provider.” As you answer these questions, please think of the in-person, phone, and video visits you had with that person in the last 6 months.Your answers are completely confidential. Simply fill out the survey below. Thank you for allowing us to be of service to you.

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A health care provider can care for patients in person, by phone, or by video. Our records show that you got care from the provider named in the email in the last 6 months. Is that right?

Yes

Is this the provider you usually see if you need a check-up, want advice about a health problem, or get sick or hurt?

Yes

How long have you been going to this provider?

Less than 6 months

At least 6 months but less than 1 year

At least 1 year but less than 3 years

At least 3 years but less than 5 years

5 years or more

In the last 6 months, did you contact this provider’s office to get an appointment for an illness, injury, or condition that needed care right away?

Yes

In the last 6 months, when you contacted this provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?

Never

Sometimes

Usually

Always

In the last 6 months, did you make any appointments for a check-up or routine care with this provider?

Yes

In the last 6 months, when you made an appointment for a check-up or routine care with this provider, how often did you get an appointment as soon as you needed?

Never

Sometimes

Usually

Always

In the last 6 months, did you contact this provider’s office with a medical question during regular office hours?

Yes

In the last 6 months, when you contacted this provider’s office during regular office hours, how often did you get an answer to your medical question that same day?

Never

Sometimes

Usually

Always

In the last 6 months, how often did this provider explain things in a way that was easy to understand?

Never

Sometimes

Usually

Always

In the last 6 months, how often did this provider listen carefully to you?

Never

Sometimes

Usually

Always

In the last 6 months, how often did this provider seem to know the important information about your medical history

Never

Sometimes

Usually

Always

In the last 6 months, how often did this provider show respect for what you had to say?

Never

Sometimes

Usually

Always

In the last 6 months, how often did this provider spend enough time with you?

Never

Sometimes

Usually

Always

In the last 6 months, did this provider order a blood test, x-ray, or other test for you?

Yes

In the last 6 months, when this provider ordered a blood test, x-ray, or other test for you, how often did someone from this provider’s office follow up to give you those results?

Never

Sometimes

Usually

Always

In the last 6 months, did you take any prescription medicine?

Yes

In the last 6 months, how often did you and someone from this provider’s office talk about all the prescription medicines you were taking?

Never

Sometimes

Usually

Always

In the last 6 months, how often were clerks and receptionists at this provider’s office as helpful as you thought they should be?

Never

Sometimes

Usually

Always

In the last 6 months, how often did clerks and receptionists at this provider’s office treat you with courtesy and respect?

Never

Sometimes

Usually

Always

Are you male or female?

Male

Female

What is the highest grade or level of school that you have completed?

8th grade or less

Some high school, but did not graduate

High school graduate or GED

Some college or 2-year degree

4-year college graduate

More than 4-year college degree

Are you of Hispanic or Latino origin or descent?

Yes, Hispanic or Latino

No, not Hispanic or Latino

What is your race? (Mark one or more.)

What types of visits did you make with this provider in the last 6 months? Check all that apply.

In Person

By Phone

By Video Call

Did someone help you complete this survey?

Yes

How did that person help you? (Mark one or more.)

Read the questions to me

Wrote down the answers I gave

Answered the questions for me

Translated the questions into my language

Helped in some other way

Thank you for your participation. Please share any additional comments you feel would be helpful.

If you would like to recognize a staff member for outstanding service, please enter the name here

If you would like a manager to contact you to discuss your experience, please enter your name and phone number here

Are you aware you can schedule appointments online?

Yes

Have you used the service?

Yes

Would you use it?

Yes

Are you aware we have a Saturday Telecare Clinic for sick visits?

Yes

Have you used the service?

Yes

Would you use it?

Yes

For new services, what is the best way to communicate to you?

Unity Health Network

2750 Front Street Cuyahoga Falls OH 44221

330-923-5899 contact@unityhealthnetwork.org