St. Charles Family Medical Center

St. Charles Family Medical Center
110 S. 17th Street, St. Charles, Illinois 60174

Tel: 630-377-2800

Fax: 630-397-7792

Survey

Please help us improve our office

Use this survey form. This survey is completely anonymous.

Whenever you’ve phoned our office, did you receive prompt, courteous attention?	Yes No
Do you feel, for the most part, you were seen promptly?	Yes No
All staff members are friendly and courteous?	Yes No
Staff members greeted you by name and made an effort to help you feel comfortable?	Yes No
The Doctors, staff and facilities have a neat, professional appearance?	Yes No
Did you find your appointment with the doctor to be thorough and complete?	Yes No
Did the Doctor spend enough time with you?	Yes No
Were you able to receive an appointment in a reasonable amount of time?	Yes No
Things you liked most about the office?
How could we improve service to our patients?
Have you referred a friend or relative to our office?	Yes No
Additional comments:

© Copyright Louis Jr. Designs - Last changed November 6, 2011