Date of Visit (mm/dd/yyyy)
Physician/Nurse Practitioner seen
Please Select
Bryan M. Cox, M.D.
Christine Delagarza, M.D.
Shannon Gallagher, M.D.
Brian W. Harle, M.D.
Heidi R. Heck, M.D.
Parke J. Hedges, M.D.
Charles R. Honore, M.D.
Tiffany Satterfield, DO
Gloria J. Nichols, WHNP
Mary Cochran-Francis, WHNP
Cheryl Bonecutter, WHNP
Scale: 1-5 (Strongly Disagree to Strongly Agree)
The person scheduling my appointment was pleasant and courteous.
Strongly Disagree
1 2 3 4 5
The office environment was comfortable and clean.
Strongly Disagree
1 2 3 4 5
The registration staff at the check-in desk was pleasant and courteous.
Strongly Disagree
1 2 3 4 5
The medical assistant who prepared me for my exam was friendly, patient and courteous.
Strongly Disagree
1 2 3 4 5
My physician/nurse practitioner listened and answered my questions.
Strongly Disagree
1 2 3 4 5
My physician/nurse practitioner helped me understand my medical condition.
Strongly Disagree
1 2 3 4 5
My physician/nurse practitioner spends an appropriate amount of time with me.
Strongly Disagree
1 2 3 4 5
Upon checkout, the checkout staff was pleasant and courteous.
Strongly Disagree
1 2 3 4 5
I would recommend SOWC to my friends/family without hesitation.
Strongly Disagree
1 2 3 4 5
After arrival, how long did you wait (including waiting room and exam room) before you saw your physician/nurse practitioner?
a. < 10 min b. 10-15 min c. 15-30 min d. > 30 min
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