We'd love to hear your thoughts about our clinic and how we can help better serve you. Please fill out the survey form below...thank you!
Please provide your contact info:
First Name: (required)
Last Name: (required)
Please tell us how you found out about Premier Urgent Care :
---Family / FriendInternet SearchTelevisionRadioWorkplaceNewspaperEmailWebsiteDoctor ReferralOtherBillboardDirect Mailer
Do you have a regular family doctor?
If Premier Urgent Care was not here, where would you have gone for treatment? :
Which location did you visit today?
Have you previously visited this location of Premier Urgent care?
How would you rate:
Overall quality of medical care?
Courtesy and helpfulness of front desk staff?
Courtesy and professionalism of Nursing staff?
During your visit were you periodically informed of the status of your treatment and offered water or other conveniences?
Based on your recent appointment, how would you rate your PROVIDER
-Listens to you
-Takes Enough Time with you
-Explains your Plan of Care
-Satisfaction with your Plan of Care.
Cleanliness and neatness at Premier Urgent Care?
Clear communication and instructions during visit?
How would you rate your WAIT TIME IN
Was the cost of your visit reasonable?
How likely would you be to refer to friends & relatives?
Overall, how would you rate your Experience?
Overall, were you satisfied enough to return to our center for medical care in the future?
Would you be willing to share your experience in Premier Urgent Care marketing initiatives?
What was the date of your visit?
We’d like to hear any comments you might have about your visit to our clinic.
To improve our services and better serve our clients, we may wish to contact you regarding your feedback. What is your e-mail address? (Note that your e-mail address will only be used to contact you if appropriate and will not be used for any other purpose.) :