United Medical, LLC

* About the Professionalism:

	Not Satisfied	Satisfied	Extremely Satisfied
How would you rate your overall experience with the visit to this healthcare professional?
Were you satisfied with the time spend during your visit with the physician?
How satsified were you with the physician's appraoch? Did the physician listen to your explanations and questions carefully?
Were you satisfied with the physician's answer to your questions?

* About the visit, facilities and staff:

	Not Satisfied	Satisfied	Extremely Satisfied
Were you satisfied with the ease of schedulig visit with the physician?
Were you satisfied with the cleanliness of the office?
How satsified were you with the friendiness of medical staff?
How would you rate the medical staff effectiveness?
Were you satisfied with the medical staff behavior when the doctor was not present?

* General comments about the health professional:

	Not Satisfied	Satisfied	Extremely Satisfied
Please enter in the box below what you believe this professional should CONTINUE DOING.
Please enter in the box below what you believe this professional should STOP DOING.
Please enter in the box below what you believe this professional should START DOING.

* Please enter in the box below what you believe this professional should CONTINUE DOING.

* Please enter in the box below what you believe this professional should STOP DOING.

* Please enter in the box below what you believe this professional should START DOING.

Your Overall Experience:

	Not Likely	Likely	Very Likely
How likely are you to recommend the services of this professional to your family and friends?
What is the likelihood you would return to this professional (assuming you need future care)?

Final Comments: