Referral Practice Survey Step 1 of 7 14% URLThis field is for validation purposes and should be left unchanged.Thank you for trusting us. To continue to provide quality GI care to your patients, we would like to get your feedback on a few aspects of our practice. Practice(s) Name* How have you contacted our office to schedule an appointment?*Select ANY that apply. EPIC Calling Fax Appointment Coordinators N/A Which is your preferred method of contacting our office?* EPIC Calling Appointment Coordinators Fax Why? Did you know that Digestive Health Specialists has appointment coordinators in place to assist you?* Yes No We have two coordinators available to assist with urgent appointment scheduling/specific scheduling requests. You may reach out to them Monday-Friday 8-5pm: Stacy: (336) 397-5255 & Marsha: (336) 397-5232 or through email at ApptCoordinator@digestivehealthspecialists.flywheelsites.com Have you contacted our appointment coordinators?* Yes No Was this helpful?* Yes No Appointment Coordinator Performance*Please rate the performance of our appointment coordinators based on the characteristics below. ExcellentVery GoodGoodFairPoorAccessibility of coordinatorsKnowledge of coordinatorsAppointment availabilityAdditional Comments:* Of the patients referred to Digestive Health Specialists, how many are for screening purposes?*(i.e. colonoscopy, endoscopy, etc) * Please indicate the most accurate percentage. 0% - 25% 26% - 50% 51% - 75% 76% - 100% Of the patients referred to Digestive Health Specialists, how many were for a diagnostic visit?** Please indicate the most accurate percentage. 0% - 25% 26% - 50% 51% - 75% 76% - 100% What are the top 3 reasons for choosing Digestive Health Specialists, for your patients?*Reason 1Reason 2Reason 3 If you could receive gastroenterology information, what topics would be of most interest?*#1#2#3 In terms of our referral experience, how would you rate Digestive Health Specialists? Appointment Availability* Excellent Very Good Good Fair Poor Ease of scheduling* Excellent Very Good Good Fair Poor Friendliness of phone scheduling staff* Excellent Very Good Good Fair Poor Quality of treatment options* Excellent Very Good Good Fair Poor Turnaround time of follow-up reports* Excellent Very Good Good Fair Poor Overall experience* Excellent Very Good Good Fair Poor Additional Comments:* TestimonialBy checking the box below, you authorize us to use the comments provided throughout this survey as part of our testimonials. I agree This survey is anonymous, but if you would like to provide your information for us to follow-up on your comments, please fill our the information below. NamePlease indicate name of person filling out this form. First Last PositionPhoneEmail Additional Comments:CAPTCHA Δ
Digestive Health Specialists
