(248) 363-7500
Quick Links
Patient Portal
Resource
Patient Forms
Insurances Accepted
Financial Policy
Home
Meet Our Providers
Appointments
Patient Forms
Financial Policy
Patient Portal
Insurances Accepted
Telemedicine
Telemedicine
Prescription Refills
After Care Survey
Covid-19 Update
Contact
Home
After Care Survey
Which physician did you see?
*
Dr. Samuel Jonnalagadda, M.D.
Dr. Alka Jain, M.D.
Jessica Graham, N.P.-C
Lana Elia, N.P.-C
Overall, how satisfied or dissatisfied were you with your last visit to our office?
*
Unsatisfied
Neutral
Satisfied
Very Satisfied
How easy or difficult was it to schedule your appointment?
*
Difficult
Neutral
Easy
How satisfied were you with the appointment time you were able to get?
*
Unsatisfied
Neutral
Satisfied
Very Satisfied
Overall, how would you rate the care you received from our staff?
*
Poor
Fair
Good
Excellent
Overall, how would you rate the care you received from your provider?
*
Poor
Fair
Good
Excellent
How well did you provider answer your questions and concerns?
*
Very Poorly
Poor
Moderately Well
Extremely well
How satisfied or dissatisfied were you with the amount of time your provider was able to spend with you addressing your needs and medical concerns?
*
Unsatisfied
Neutral
Satisfied
Very Satisfied
How satisfied are you with our website?
*
Unsatisfied
Neutral
Satisfied
Very Satisfied
Did you sign up for our new patient portal?
*
I did sign up for the portal
I did not sign up for the portal, but plan to
Not interested at this time
How likely is it that you would recommend Commerce Primary Care to a friend or family member? (rating 0-10)
*
0 - Never
1
2
3
4
5
6
7
8
9
10 - Very Likely
Is there anything we could have done to improve your last visit?
CAPTCHA
Comments
This field is for validation purposes and should be left unchanged.