Patient Care Survey

The most important part of RGI's service is meeting our Patient needs. Please take the time to complete the Patient Care Survey by specifying how well we are doing in meeting your needs. We appreciate your feedback. Where indicated* , please rate on a scale of 1 to 10, with 10 indicating very good and 1 indicating very poor.

First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zipcode:
Country:
e-Mail:
Re type e-Mail:
Phone:
Front Desk Responsiveness:
Front Desk Pleasantness:
Waiting Room Comfort:
Medical Staff Treatment:
Medical Staff Professionalism:
Appointment Scheduling:
Billing Staff Accuracy:
Billing Staff Counsel:
Website Helpfulness:
Overall Assessment of RGI:
Comments or areas needing improvement: