Norman's Newest and Most Advanced, Dedicated Endoscopy Center
Call Us Today: (405)366-0969

NEC Patient Evaluation

Norman Endoscopy Center Patient Evaluation

You deserve the best medical care available.  We hope that you are satisfied with the care that you received while at our facility.  Please take the time to answer the questions below and return the survey to us.  Your suggestions for improvement are most welcome.  Also, feel free to recognize any employee who made your visit more comfortable. Thank you for your assistance.

Your Name (not required)

Your Address, City, State & Zip (not required)

Your Email (required)

Physician (required)

Date of Service (required)

Please click the circle that you feel best describes how we are doing in the following areas:

Prior to your Procedure:

The information provided to you about preparing for your procedure:

 Great (5) Good (4) OK (3) Fair (2) Poor(1)

My questions about billing were explained:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Upon arrival an employee welcomed me in a friendly manner:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Time waiting prior to the procedure:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Delivery of Care:

My physician explained the risks and benefits of procedure and answered my questions:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Prior to procedure, my nurse or physician explained the procedure and recovery with me:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Did you feel your pain was controlled at acceptable level to you?

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

My expectations of the procedure were met:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Discharge instructions that were provided to you or your responsible party:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

My confidentiality and personal dignity were respected:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

The Center provided for my safety and well-being during my stay:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Staff:

Nursing staff’s personal manner (courtesy, respect, sensitivity, friendliness):

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Staff answered my questions and spent enough time with me:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

General:

Comfort and Safety while waiting:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

Likelihood of referring your friends and relatives to us:

 Great (5) Good (4) OK (3) Fair (2) Poor (1)

List any complications:

What did you like best about our center?

What did you like least about our center?

Any Additional Comments

Norman Gastroenterology Associates

Click on the NGA logo below for more information on Dr. Charles L. Lackey, Dr. Robert M. Holbrook, or Dr. Joshua D. Whorton, the owners of Norman Gastroenterology Associates, or to make an appointment with NGA.

Norman Gastroentorology Associates

Contact Us:

Norman Endoscopy Center
1515 N. Porter, Suite 100
Norman, OK 73071
Phone (405) 366-0969
Fax (405) 701-3734

Norman Gastroenterology Associates
Charles L. Lackey, M.D.
Robert M. Holbrook, M.D.
Joshua D. Whorton, M.D.
1515 N. Porter, Suite 200
Norman, OK 73071
Phone (405) 366-8619
Fax (405) 366-1839

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