Pioneer Medical Group

Scheduling Your Appointment

Strongly
Agree

Strongly
Disagree

Your phone calls are usually answered promptly.

Our receptionist is always friendly and helpful.

You can schedule a convenient / timely appointment with your physician.

Our hours of operation are convenient for you.

Your physician answers your calls promptly.

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Dear Member,
We are continually striving to improve our services to make your healthcare experience more satisfying. Please take a few moments to answer the following questions. Your answers will remain anonymous unless you choose to identify yourself. Thank you for participating.

Your Appointment	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
You usually wait less than 20 minutes to see your physician.	1	2	3	4	5
Your physician's nurse is always helpful and courteous.	1	2	3	4	5
Your physician is always professional and courteous.	1	2	3	4	5
Your physician listens to all of your concerns.	1	2	3	4	5
Your physician answers all of your questions.	1	2	3	4	5
Your physician adequately explains any tests or treatment options.	1	2	3	4	5
You are able to make a convenient / timely appointment for follow-up care.	1	2	3	4	5
You usually receive your test results in a timely manner.	1	2	3	4	5

Facilities
Was the office clean?	Yes	No
Were the examining rooms clean?	Yes	No
Were the restrooms clean?	Yes	No

Operations
Do you know Pioneer Medical Group has after-hours clinics?	Yes	No
Do you know the after-hours clinics are open for non-appointment care M-F 6pm-9pm, Saturday 9am-5pm and Sunday 9am-1pm?	Yes	No
Do you know that most of our physicians have extended hours for early morning and evening appointments?	Yes	No
Have you previously visited our website at www.pioneermedicalgroup.com?	Yes	No
Did you know our website contains useful information and tools for maintaining your health at My Health Zone?	Yes	No
Are there additional services we can provide for you?	Yes	No
Would you refer a friend to your physician?	Yes	No
If yes, please explain:
Pioneer Medical Group likes to be an active member in the community. Do you know of any upcoming community events where we can volunteer our services?
Additional Comments:

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Telephone number if you would like a follow-up call to discuss your concerns:

Corporate Address: 17777 Center Court Drive, Suite 400, Cerritos, CA 90703. Phone: (562) 229-9452 Fax: (562) 229-0952.
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