Patient Survey

Please fill-out the survey below and let us know how your experience was with us. We take input from our patients seriously and guarantee your confidentiality.

General Information

Patient Name: *

Type of Appointment: *

Physician Seen: *

Scheduling

Was scheduling with our staff a smooth process?:

Yes

Was our staff courteous and helpful?:

Yes

How long did it take you to get an appointment?:

Less than 1 week

1-2 weeks

3-4 weeks

Other (specify in comments)

Were you advised with what information you would need to bring to your appointment?:

Yes

Reception

Was the Administrative Assistance helpful and informative at check-in?:

Yes

How long was your wait in the wait room?:

Under 15 minutes

15-30 minutes

30-45 minutes

45-60 minutes

Other (please specify in comments)

Were you informed that the physician was delayed?:

Yes

Clinical

Was the Medical Assistant helpful and informative?:

Yes

How long did you wait in your room for the physician?:

Under 15 minutes

15-30 minutes

30-45 minutes

45-60 minutes

Other (please specify in comments)

Did you have xrays in our office?:

Yes

Was the xray tech helpful and informative? (if applicable):

Yes

Do you feel the physician addressed your questions and concerns in a way that you could understand?:

Yes

Do you feel that options for your treatment and instructions for your care were explained in a way that you could understand?:

Yes

Billing

Did you have any billing questions or concerns?:

Yes

If Yes, did the billing staff and your questions or concerns in a helpful manner?:

Yes

Other

How would you rate your overall experience at Mountain Orthopaedics?:

Excellent

Good

Fair

Poor

Would you like a response from our Office Manager?:

Yes

E-mail (optional):

Additional Information:

Locations

Bountiful Locationmap
1551 Renaissance Towne Dr.
Bountiful, UT 84010
801-295-7200

Layton Locationmap
2086 N 1700 W, Ste. A
Layton, UT 84041
801-295-7200

Hours
M-F 8:00 A.M. to 5:00 P.M.