Via Christi Clinic - Working together for your good health.

Patient Experience

Please note that this survey is intended to be anonymous. If you are interested in receiving follow-up to information that you have submitted you will need to make sure to include your name. You can also use our Compliment/Complaint/Concern form on our Contact Us page to submit your comments.

Why did you select Via Christi Clinic?

	Family, Friend or Coworker
	Physician Referral
	Insurance
	Location
	Advertising/Media Interviews (Ads, Television, Radio)
	Phone book
	Website
	Other

Did you have enough time to address issues, questions, and concerns with your physician?

	Yes
	No

Please select the location where you had your patient visit:

	Poor	Fair	Good	Very Good	Excellent
Hours of Operation

Phone Service

Accommodations (cleanliness, comfort...)

Physician or Provider (PA, ARNP)
Level of skill
Personal manner (courtesy, respect…)
Information provided/complete responses

Nursing Staff
Level of skill
Personal manner (courtesy, respect…)
Information provided/complete responses

Other Staff (Lab, Pharmacist)
Level of skill
Personal manner (courtesy, respect…)
Information provided/complete responses

Office Staff (Receptionist, Patient Registration)
Personal manner (courtesy, respect…)
Information provided/complete responses

Overall Visit

Would you recommend Via Christi Clinic to a family, friend or coworker?

	Yes
	No

Please explain why you would or would not recommend Via Christi Clinic.

Additional comments, compliments or concerns about your experience at Via Christi Clinic?

Share Your Thoughts | Patient Experience | Website Experience

3311 E Murdock, Wichita, KS 67208 — 316-689-9111

Via Christi Clinic is a tobacco-free organization. Smoking and the use of all tobacco products is prohibited inside buildings and on all properties.

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