Patient Satisfaction Survey Step 1 of 8 12% Name First Last PhoneEmail Name First Last Please indicate the name of your provider: Nirav Bigelow PhD, PsyD Christopher Bojrab, MD Andrew Brothers, PhD Deborah Bykowski, PMHNP-BC Deborah Carpenter, PMHCNS-BC Kathleen Chesterfield, LMFT, CMT Katherine (Katie) Clendenen, LMHC Beili Dong, MD Jenna Doyle, LMHC Christina Falink, LCSW Corey Falink, LMHC Tyler Flaningham, MD Jessica Fogle, LCSW Elizabeth Goebel, LMHC Marcy Haboush, LCSW Kirsten Hammersley, PMHNP-BC Marabeth Holland, LMHC Beverly Inman-Dunigan, LCSW Elizabeth Irick, LMHC Shiela Irick, MD Jennifer Jansen, LCSW Robert Jeffries, PhD Rich Jones, PhD Nancy Jungemann, PMHNP-BC Kim Keller, LMHC Seth Kleiman, LMHC Kourtney Klepfer, LCSW Maryann Lake, LCSW Bethany Littrell, LMHC Danita Lively, MD Barbara Logan, PMHNP-BC Darrin Mangiacarne, DO Christine Miller, DO Scott Minnich, MSW, LSW Sanjay Mishra, MD Laurie Moyer, LCSW, ATR Jennifer Myers, LCSW Shaunna Norris, LCSW Jill Oliver, PMHCNS-BC Terry Parrish, MD Tina Ramseur, LMHC Jane Rapinchuck MD Michelle Rinzel, LCSW Mary Roth, LCSW Carrie Schaefer, LCSW Camille Sexton-Villalta, PhD Dan Shelpler, PMHNP-BC Jim Shoot, MD Francia Siler, LCSW Jenn Stepic-Wenzel, LMHC Michael Webber, MD Steve Wilson, PMHCNS-BC Polly Westcott, PsyD Other/Not Listed The questions below pertain to your experience with the provider listed above.Timeliness of the start of appointment Above Average Average Neutral Below Average N/A Amount of time spent in appointment: Above Average Average Neutral Below Average N/A Professionalism: Above Average Average Neutral Below Average N/A Connection Made: Above Average Average Neutral Below Average N/A I felt like I was "heard": Above Average Average Neutral Below Average N/A Overall experience: Above Average Average Neutral Below Average N/A Have you seen any other providers at Indiana Health Group? Yes No Please indicate the name of your provider: Nirav Bigelow PhD, PsyD Christopher Bojrab, MD Andrew Brothers, PhD Deborah Bykowski, PMHNP-BC Deborah Carpenter, PMHCNS-BC Kathleen Chesterfield, LMFT, CMT Katherine (Katie) Clendenen, LMHC Beili Dong, MD Jenna Doyle, LMHC Christina Falink, LCSW Corey Falink, LMHC Tyler Flaningham, MD Jessica Fogle, LCSW Elizabeth Goebel, LMHC Marcy Haboush, LCSW Kirsten Hammersley, PMHNP-BC Marabeth Holland, LMHC Beverly Inman-Dunigan, LCSW Elizabeth Irick, LMHC Shiela Irick, MD Jennifer Jansen, LCSW Robert Jeffries, PhD Rich Jones, PhD Nancy Jungemann, PMHNP-BC Kim Keller, LMHC Seth Kleiman, LMHC Kourtney Klepfer, LCSW Maryann Lake, LCSW Bethany Littrell, LMHC Danita Lively, MD Barbara Logan, PMHNP-BC Darrin Mangiacarne, DO Christine Miller, DO Scott Minnich, MSW, LSW Sanjay Mishra, MD Laurie Moyer, LCSW, ATR Jennifer Myers, LCSW Shaunna Norris, LCSW Jill Oliver, PMHCNS-BC Terry Parrish, MD Tina Ramseur, LMHC Jane Rapinchuck MD Michelle Rinzel, LCSW Mary Roth, LCSW Carrie Schaefer, LCSW Camille Sexton-Villalta, PhD Dan Shelpler, PMHNP-BC Jim Shoot, MD Francia Siler, LCSW Jenn Stepic-Wenzel, LMHC Michael Webber, MD Steve Wilson, PMHCNS-BC Polly Westcott, PsyD Other/Not Listed Timeliness of the start of appointment Above Average Average Neutral Below Average N/A Amount of time spent in appointment: Above Average Average Neutral Below Average N/A Professionalism: Above Average Average Neutral Below Average N/A Connection Made: Above Average Average Neutral Below Average N/A I felt like I was Above Average Average Neutral Below Average N/A Overall experience: Above Average Average Neutral Below Average N/A Have you seen any other providers at Indiana Health Group? Yes No Please indicate the name of your provider: Nirav Bigelow PhD, PsyD Christopher Bojrab, MD Andrew Brothers, PhD Deborah Bykowski, PMHNP-BC Deborah Carpenter, PMHCNS-BC Kathleen Chesterfield, LMFT, CMT Katherine (Katie) Clendenen, LMHC Beili Dong, MD Jenna Doyle, LMHC Christina Falink, LCSW Corey Falink, LMHC Tyler Flaningham, MD Jessica Fogle, LCSW Elizabeth Goebel, LMHC Marcy Haboush, LCSW Kirsten Hammersley, PMHNP-BC Marabeth Holland, LMHC Beverly Inman-Dunigan, LCSW Elizabeth Irick, LMHC Shiela Irick, MD Jennifer Jansen, LCSW Robert Jeffries, PhD Rich Jones, PhD Nancy Jungemann, PMHNP-BC Kim Keller, LMHC Seth Kleiman, LMHC Kourtney Klepfer, LCSW Maryann Lake, LCSW Bethany Littrell, LMHC Danita Lively, MD Barbara Logan, PMHNP-BC Darrin Mangiacarne, DO Christine Miller, DO Scott Minnich, MSW, LSW Sanjay Mishra, MD Laurie Moyer, LCSW, ATR Jennifer Myers, LCSW Shaunna Norris, LCSW Jill Oliver, PMHCNS-BC Terry Parrish, MD Tina Ramseur, LMHC Jane Rapinchuck MD Michelle Rinzel, LCSW Mary Roth, LCSW Carrie Schaefer, LCSW Camille Sexton-Villalta, PhD Dan Shelpler, PMHNP-BC Jim Shoot, MD Francia Siler, LCSW Jenn Stepic-Wenzel, LMHC Michael Webber, MD Steve Wilson, PMHCNS-BC Polly Westcott, PsyD Other/Not Listed Amount of time spent in appointment: Above Average Average Neutral Below Average N/A Professionalism: Above Average Average Neutral Below Average N/A Connection Made: Above Average Average Neutral Below Average N/A I felt like I was Above Average Average Neutral Below Average N/A Overall experience: Above Average Average Neutral Below Average N/A New Patient ReviewWas this your first visit to Indiana Health Group? Yes No Did you utilize our online New Patient Pre-Registration Form? Yes No Did you experience any issues during the scheduling process? Yes No How could we improve our process?Did our New Patient Coordinator greet you with a smile? Yes No The questions below pertain to your experience with our NEW PATIENT COORDINATORS:Ability to reach our office: Above Average Average Neutral Below Average N/A Courtesy & Professionalism during your initial telephone call: Above Average Average Neutral Below Average N/A Length of time waiting to check in / out: Above Average Average Neutral Below Average N/A Courtesy & professionalism at the time of CHECK-IN: Above Average Average Neutral Below Average N/A Knowledge of our New Patient Coordinators: Above Average Average Neutral Below Average N/A Front OfficePlease indicate the front office team member that checked you IN: Unknown/Not Listed Allison Annabelle Carlie Chelsea Jazz Leigha Marilyn Sam Were you greeted with a smile? Yes No Please indicate the front office team member that checked you OUT: Unknown/Not Listed Allison Annabelle Carlie Chelsea Jazz Leigha Marilyn Sam The questions below pertain to your experience with our FRONT OFFICE STAFF:Ability to reach our office: Above Average Average Neutral Below Average N/A Courtesy and professionalism during your most recent TELEPHONE CALL: Above Average Average Neutral Below Average N/A Length of time waiting in line at the time of CHECK-IN: Above Average Average Neutral Below Average N/A Courtesy and professionalism at the time of CHECK-IN: Above Average Average Neutral Below Average N/A Length of time waiting in line at the time of CHECK-OUT: Above Average Average Neutral Below Average N/A Courtesy and professionalism at the time of CHECK-OUT: Above Average Average Neutral Below Average N/A Overall experience with our FRONT OFFICE: Above Average Average Neutral Below Average N/A Facility & TechnologyPlease rate our FACILITY:Lobby: Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Restrooms: Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Waiting Rooms: Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Clinical Providers Office: Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Overall Facility: Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Please rate our TECHNOLOGY:New Patient Pre-Registration Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Telehealth - Doxy.me Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Website Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Patient Portal - My Medical Locker Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Telephone System Exceptional Acceptable Neutral Unacceptable Needs Improvement N/A Please share any compliments, comments, or suggestions you may have so that we can better serve you:Would you like a call from our office manager to discuss your experience?(Required) Yes No
