Bardmoor | Clearwater | Palm Harbor
Safety Harbor | St. Petersburg | Trinity


Patient Satisfaction Report Card

We want to provide the best quality medical care possible. To do that, we need your feedback to help us improve. Please complete this form and send it by clicking the submit button below.

If you need assistance related to appointments or scheduling, please call the location directly.

How did you first hear of us?


If a doctor referred you, please list his or her name so we may thank him or her for the referral.

Level of Satisfaction
Very Satisfied
Somewhat Satisfied
Not at all satisfied
The doctor's explanation of your medical problem
The amount of time the doctor spent with you
The doctor's genuine concern for you and your problem
The ease of making an appointment

The friendliness and courtesy shown by the front
office staff

Amount of time you spent in the office waiting to be seen
Convenience of office location
How phone calls are handled
The overall care provided to you

How likely would you be to recommend the clinic to a friend?

Do you think our clinic is the best place to go compared to other clinics
in the area?

What is your age?


Thank you for the privilege of caring for you.



Home | Administration | Locations: Urology Specialists of West Florida 1 in Clearwater, Bardmoor, Palm Harbor | Urology Specialists of West Florida 2 - Urology Consultants in Safety Harbor, Trinity, Tampa | Urology Specialists of West Florida 3 in New Port Richey, Tampa, Trinity, Palm Harbor | Urology Specialists of West Florida 4 - Pinellas Urology in St. Petersburg | Urology Specialists of West Florida Radiation Oncology Center in Clearwater | Our Doctors | Patient Education for Urology Conditions | Post-Operative Instructions for Urology Patients | Latest Technology for Urological Conditions | Urology Specialists of West Florida In the News


The pictures displayed in are images of physicians, patients and employees who have consented to have their pictures in this website.

Copyright © 2017 MedIngenuity, LLC
Web Development for Urology



Click here to learn about our oncology care center that helps patients with prostate cancer return to active healthy lives.