Patient Satisfaction Survey

Thank you for taking the time to complete our patient satisfaction survey. There are two options below, please either print the PDF survey and mail it in, or complete the survey online.

Complete the PDF Survey

You may download and print the PDF survey here: Patient Survey (267 KB)

Please return your completed survey either by email or mail:

By Email:
Please send to Michelle Naugle at: mnaugle@nomshealthcare.com

By Mail:
Please send to the address stated below:
NOMS Healthcare
C/O Michelle Naugle, RMA
2500 W. Strub Rd., Suite 360
Sandusky, Ohio 44870

Complete the Online Survey

Tell us about your appointment Extremely Dissatisfied Very Dissatisfied Satisfied Very Satisfied Extremely Satisfied
Ease of making appointments for checkups (physical exams, well visits, routine follow-up appointments)? *
Ease of making appointments for sickness? *
Tell us about our office and staff Extremely Dissatisfied Very Dissatisfied Satisfied Very Satisfied Extremely Satisfied
Ease in contacting your doctor when our office is closed (nights and weekends)? *
Ease in speaking directly with your doctor by telephone when you call during office hours *
The time it takes someone from our office to respond when you call the office with an urgent problem *
Waiting time in our office *
Ease in obtaining follow-up information and care (test results, medicines, care instructions) *
Overall medical care at your doctor’s office *
Our office’s appearance *
Our office’s convenience (location, parking, hours, office layout) *
The way we teach you about improving your health *
The way your doctor involves other doctors and caregivers in your care when needed *
Level of care Extremely Dissatisfied Very Dissatisfied Satisfied Very Satisfied Extremely Satisfied
How caring is your doctor *
How caring is our medical staff *
How caring is our office staff *
Recommendations Extremely Dissatisfied Very Dissatisfied Satisfied Very Satisfied Extremely Satisfied
Would you recommend your doctor to your family or friends *

By submitting your survey, you are giving permission to NOMS Healthcare to use your first name, last name initial and remarks on future marketing materials.