215 E. MANSION STREET, SUITE 3D
MARSHALL, MI 49068

269.781.1183 | 269.781.9248 (fax)

269.789.9298 (After hours emergency)
reception1@mansionstobgyn.com

3600 CAPITAL AVE SW, SUITE 205
BATTLE CREEK, MI 49015

269.719.8046 | 269.719.8049 (fax)

Forms for First Visit Payment/Insurance Privacy Policy

Login to review your account, see appointments and keep track of your medical records. Go to Patient Login.

Patient Survey

 

Thank you for choosing Mansion Street Women’s Health! We are here to render caring, quality health care, promptly and professionally, in a pleasant and friendly atmosphere. In an effort to continue to maintain high standards of excellence and patient satisfaction, we ask that you fill out the following survey. Your responses and suggestions matter as we strive to provide you with the best patient experience! All information will be kept confidential. Thank you for your time!

 

Name
(Optional – we appreciate you providing your name should we like to discuss any of your answers or comments)

Email Age

Date of Visit / / Location

Type of Appointment

If here for Ultrasound, how was your experience with Brittani / Sonographer?

If here for lab services, how was your experience with Talonda / Phlebotomist?


Please indicate how well you think we are doing in the following areas:

Ease of getting care
 

Ability to get in to be seen

Office Hours

Convenience of location

Prompt scheduling / return phone calls

 

 

Waiting
 

Time in waiting room

Time in exam room

Promptness in getting test results

 

 

Practice Environment
 

Neat & clean office

Comfort while waiting


Provider
 

Which provider did you see today?

Listens to you

Takes enough time with you

Explains all information

Answers all your questions

Friendly and helpful to you

Helps you feel relaxed / at ease

 

 

Which nurse assisted you?

Listens to you

Takes enough time with you

Explains all information

Answers all your questions

Friendly and helpful to you

Helps you feel relaxed / at ease


Receptionist
 

Who assisted you today?

Greeted in a timely manner

Friendly & courteous

Answers all of your questions


Billing
 

Who assisted you today?

Greeted in a timely manner

Friendly & courteous

Answers all of your questions

Explanation of charges


The likelihood of referring your friends and relatives to us

What do you like best about our office?

What improvements does our office need to make?

Suggestions / Comments


Other services you would like to see offered by MSWH?


Would you like to be contacted by our office manager?
If so, please list phone 


 


Since 1995, Mansion Street Women's Health
has been specializing in exceptional obstetrical and gynecological care, addressing and treating a wide range of women's health care issues, and performing procedures and surgeries with compassionate care.