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The University of Texas Health Science Center (UTHealth) at Houston

Department of Diagnostic & Biomedical Sciences

Oral Pathology Laboratory

7500 Cambridge Suite 6110

Houston, TX 77054

713-486-4407

We appreciate you taking a few minutes to answer a few questions about our biopsy service and the level of service you feel you received from our pathologists and staff. Thank you!

On a scale of 1 to 5 (1 = Strongly Disagree and 5 = Strongly Agree), please rate the following.
If you would like to add any additional comments, good or bad, please do so in the comment section below.

**On a scale of 1 to 5 (1 = Strongly Disagree and 5 = Strongly Agree), please rate the following.**
**If you would like to add any additional comments, good or bad, please do so in the comment section below.**
	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
Calls were answered promptly	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
Calls were answered courteously	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
Specimens were easy to submit	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
Results were received in a timely manner	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
The pathology report was easy to access	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
The pathology report was of good quality	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
Biopsy supplies were easy to obtain	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
Interaction with pathologist was helpful	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
The billing department was easy to contact	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable
The overall experience was good	1 - Strongly Disagree	2 - Disagree	3 - Neither Disagree nor Agree	4 - Agree	5 - Strongly Agree	6 - Not Applicable

Comments:

Did you receive an exceptional level of service from one of our team members that you would like to recognize?

Please describe below so that we can let them know they made a positive difference and did a great job.

Doctor's Office Name (Optional):