Rate Your Visit

How Are We Doing?

Please Note: Please complet our online survey or
download the pdf version and
mail it to the address listed below.

At Crossroads OB/GYN it is our intention to provide exceptional medical care to all of our patients.

In order to better serve you, we would appreciate you taking the time to complete the following survey. If you would like your answers to remain confidential, please do not include your name at the bottom of this survey. If you would like fill it out by hand, please print out the pdf version, fill it out and mail to:

Crossroads OB/GYN
Attn: Administration
4881 E. Grant Rd.
Tucson, AZ 85712

Please indicate your experience with Crossroads OB/GYNby using the following scale:

1 – exceeds expectations
2 – mostly exceeds expectations
3 – meets expectations
4 – mostly meets expectations
5 – below expectations

When you called to schedule your appointment:
Was your call answered timely?	1 2 3 4 5
If you left a message, did you receive a return call within an acceptable period of time?	1 2 3 4 5
Was your appointment scheduled on a convenient day and time?	1 2 3 4 5
Was our scheduling representative professional, courteous and friendly?	1 2 3 4 5
Comments:
When you arrived for your appointment:
Was our front office staff professional, courteous and friendly?	1 2 3 4 5
Were you escorted to an exam room within a reasonable amount of time after your scheduled appointment time?	1 2 3 4 5
Was our lobby comfortable?	1 2 3 4 5
Comments:
When you entered your exam room:
Was your exam room clean and neat?	1 2 3 4 5
Was the clinical staff professional, courteous, and friendly?	1 2 3 4 5
Did you feel you had enough time with your provider?	1 2 3 4 5
Did your provider answer all your questions?	1 2 3 4 5
Do you feel your provider cared about your needs?	1 2 3 4 5
Comments:
When checking out:
Was the staff professional, courteous and friendly?	1 2 3 4 5
Did the staff answer your questions in a professional and knowledgeable manner?	1 2 3 4 5
If you made a payment during your visit, were you supplied with a detailed receipt?	1 2 3 4 5
If a follow-up appointment or test was scheduled, were you provided with an appointment card?	1 2 3 4 5
Comments:
Overall, how would you rate our performance as a medical group committed to the health and well being of women?	1 2 3 4 5
Comments:
If you would like to speak to someone regarding your experience with Associates in Women's Health Care, PLLC, please provide your name, telephone number and the best time to reach you. Name Email Best time to call am pm Phone number