Heartland Women's Health logo
Gynecology and Obstetric Services
Phone: (316) 858-7100 ~ Wichita, KS

THANK YOU FOR CHOOSING HEARTLAND WOMEN’S HEALTH, PA

Dear Patient:

Our goal is to provide comfort, convenience, and satisfaction as well as the very best medical care to all our patients. We'd like to know how you feel about our medical services, physicians, and staff members. Your comments are greatly appreciated and will help us evaluate our operations to ensure we are truly responsive to your needs. Thank you for taking the time to give us your input.
Doctor seen this visit: If other, please state:
Would you recommend our clinic to a family member or friend?
Yes
No
Have you ever changed doctors in order to obtain better service?
Yes
No
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If "other" please state:
Please rate our services.
Very Satisfied
Somewhat Satisfied
Somewhat Dissatisfied
Very Dissatisfied
Convenience of appointments

Waiting time in the reception area
Waiting time in the exam room
Handling of your phone calls by office staff
Handling of your phone calls by our after-hours answering service
Treatment of you by the receptionists
Concern and empathy shown by our nurses for you and your problems
Care and professionalism shown by our business office staff
Answers to your questions about insurance forms and payment
The explanation of your illness and treatment by the doctor
Time taken by the doctor to answer your questions
Your doctor spending enough time with you
Our office returning your calls within a reasonable amount of time
The comfort of our facilities
Charges for services rendered
Billing and payment procedures
Convenience of office hours
Is there anything we can do to improve our services to you and your family?

Please feel free to include optional contact information:

Name Email
Street Address City
State Zip
Phone: (316) 858-7100 Fax: (316) 858.7103
9300 E. 29th N. Suite 320, Wichita, KS 67226
3636 N. Ridge, Bldg 100, Suite 2, Wichita, KS 67205
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