Patient Survey

Dr. Mantas strives to create a better practice but he can only do so with your input. After your visit and at your convenience please complete the questionnaire below. Thank you for your time and rest assured that your patient survey will remain confidential and anonymous.

Survey: 0 = Poor, 1 = Fair, 2 = Good, 3 = Excellent

1. Ease of scheduling appointment.

0 - Poor1 - Fair2 - Good3 - Excellent

2. Our helpfulness on the telephone.

0 - Poor1 - Fair2 - Good3 - Excellent

3. Waiting time in the reception area.

0 - Poor1 - Fair2 - Good3 - Excellent

4. Our sensitivity to your needs.

0 - Poor1 - Fair2 - Good3 - Excellent

5. Overall care received during your visit.

0 - Poor1 - Fair2 - Good3 - Excellent

6. Concern nurse/assistant showed for your questions.

0 - Poor1 - Fair2 - Good3 - Excellent

7. Concern provider showed for your questions.

0 - Poor1 - Fair2 - Good3 - Excellent

8. Your confidence in this provider.

0 - Poor1 - Fair2 - Good3 - Excellent

9. Instructions given about follow-up care and/or medications.

0 - Poor1 - Fair2 - Good3 - Excellent

10. Likelihood of referring your friends or relatives to us.

0 - Poor1 - Fair2 - Good3 - Excellent

Security Question