St. John's Nurse on Call

Physician Satisfaction Survey

You recently used the services of St. John's Nurse On Call at St. John's Health System. Please rate the services you received. Select the button that best represents your feelings. If you had no experience with a particular service or item, select N/A.

Thank you!

		Very poor	Poor	Good	Very good	N/A
Helpfulness of the nurse
Accuracy of information given to patient
Extent to which protocols are followed
Appropriateness of dispositions
Quality of follow-up information
Overall quality of service
Likelihood of recommending the service

By using the St. John's Nurse Triage Service, the numbers of pages I am receiving has decreased by:
0-25%	25-50%	50-75%	No decrease

Do your patients feel that they have adequate access to you?
Yes	No

Are your patients satisfied with the service they are receiving from Nurse On Call?
Yes	No

I would like to receive a phone call to discuss further.
Yes	No

Physician name:
Phone number:

St John's Health System, Nurse on Call, Springfield, Missouri, USA