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At East Cobb Urgent Care,it is important to us to create a caring, service oriented environment for our patient care. We hope that you will take a moment of your time to fill out the following survey so that we can ensure our ability to meet the needs of you and your family.

Thank you for your time.


Mark Winokur, M.D.
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Lonnie King, M.D.
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Please select the most appropriate response
 
Your Visit:
Waiting time in the reception area:
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
Waiting time in the exam room:
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
Our Staff:
How would you rate your interaction with our office staff?
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
How could we improve our staffs service today?
 
How would your rate your physicians care?
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
How could your physician improve his/her care?
 
Our Facility:
Hours of operation convenient to you:
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
Overall comfort:
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
Signage and directions easy to follow:
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
Cleanliness of facility:
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
 
Do you have one or more suggestions to improve your experience with our facility?
 
How did you hear about East Cobb Urgent Care?
Brochure/Flyer Word of mouth Banner
Advertisement Saw sign Other
 
Name (optional):
Email (optional):
Date Seen (optional):