SVT Health Center with clinics in Homer, Seldovia, and Anchor Point

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We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.

1. Some personal information

Thank you for completing our Survey! Highlighted fields are required. This form contains spamlike elements.
Your Age:
Your Sex:	Male Female
Your Race/Ethnicity:	Asian Pacific Islander Black/African American American Indian/Alaska Native White (Not Hispanic or Latino) Hispanic or Latino (All Races) Unknown

2. Please rate how well you think we are doing in the following areas:

Great

Good

Fair

Poor

N/A

Ease of getting care:

Ability to get in to be seen

Hours Center is open

Convenience of Center's location

Prompt return on calls

Waiting:

Time in waiting room

Time in exam room

Waiting for tests to be performed

Waiting for test results

Provider: (Physician, Dentist, Physician Assistant, Nurse Practitioner)

Listens to you

Takes enough time with you

Explains what you want to know

Gives you good advice and treatment

Nurses and Medical Assistants:

Friendly and helpful to you

Answers your questions

All Other Staff:

Friendly and helpful to you

Answers your questions

Payment:

What you pay

Explanation of charges

Collection of payment/money

Facility:

Neat and clean building

Ease of finding where to go

Comfort and Safety while waiting

Privacy

Confidentiality:

Keeping my personal information private

Referrals:

The likelihood of referring your friends and relatives to us

3. Please share your thoughts:

Do you consider this center your regular source of care?	YES NO
What do you like best about our center?
What do you like least about our center?
Suggestions for improvement?