Patient Satisfaction Survey Please tell us how you feel about the services we provide in order to ensure we are meeting your needs. Your responses are directly responsible for improving these services. Please enable JavaScript in your browser to complete this form.Date of your visit *Which health center did you visit? *Select oneBloomington Community Health CenterBloomington Family Wellness CenterUniversity Community Health CenterMagnolia Community Health CenterMoreno Valley Family Health CenterFallbrook Family Health CenterWhich service(s) did you visit? *Select oneMedicalDentalWomen's HealthPrenatal CareBehavioral HealthVision CareChiropractic CareMultiple ServicesMy call was answered within 3 ringsYesNoN/AThe staff that I encountered throughout the clinic were helpful and courteous YesNoN/AWaiting time in the reception area was reasonableYesNoN/AMy doctor gave me the respect and time I needed to express my concernsYesNoN/AI was given a copy of my patient plan after my visit todayYesNoN/AThe clinic helps me obtain specialty care for my eyes (Optometry), teeth (Dental), and mental well-being (Behavioral Health)YesNoN/AI feel my Care Team (my provider, nurse, and medical assistants) cares about meYesNoN/AI am satisfied with the care I received today from my Care TeamYesNoN/AI will refer a friend or relative to the clinic in the futureYesNoN/ASuggestions & CommentsWould you like to be contacted by our customer service team?YesNoIf yes, please provide contact information belowNamePhone NumberEmailSubmit
