Survey 1. Which AP Urgent Care location did you visit?Thousand Oaks - 166 N. Moorpark Rd.North Hollywood - 11126 Chandler Blvd.West Hills - 22950 Vanowen StreetMoorpark - 35 W. Los Angeles Ave2. What date did you visit AP Urgent Care? Date Format: MM slash DD slash YYYY 3. How were you referred to AP Urgent Care? Referred by family/friend Physician Google search Yelp Drive By My insurance referred me Other (please specify) 4. Please rate the following aspects of your visit at AP Urgent Care. Strongly Agree Agree Satisfactory Disagree Office hours are convenient for me.Strongly AgreeAgreeSatisfactoryDisagreeOffice is easy to find.Strongly AgreeAgreeSatisfactoryDisagreeThe parking is adequate.Strongly AgreeAgreeSatisfactoryDisagreeBuilding and office are clean and attractive.Strongly AgreeAgreeSatisfactoryDisagreeReceptionist greeted me in a friendly manner.Strongly AgreeAgreeSatisfactoryDisagreeStaff was helpful regarding my insurance coverage and applicable co-payments.Strongly AgreeAgreeSatisfactoryDisagreeReception area was comfortable and neat.Strongly AgreeAgreeSatisfactoryDisagreeMy wait time was acceptable.Strongly AgreeAgreeSatisfactoryDisagreeThe exam room was clean and well organized.Strongly AgreeAgreeSatisfactoryDisagreeThe clinical staff was courteous and helpful.Strongly AgreeAgreeSatisfactoryDisagreeThe physician was knowledgeable and courteous.Strongly AgreeAgreeSatisfactoryDisagreeI received post visit information about my labs and/or x-rays.Strongly AgreeAgreeSatisfactoryDisagreeThe procedures, treatment or tests were thoroughly explained and my questions were answered.Strongly AgreeAgreeSatisfactoryDisagreeI received instructions on how to care for my condition.Strongly AgreeAgreeSatisfactoryDisagreeI will return for future medical care.Strongly AgreeAgreeSatisfactoryDisagreeI will recommend AP Urgent Care to family and friends.Strongly AgreeAgreeSatisfactoryDisagreePlease share other comments here:5. I prefer to receive health care services during my non-business hours.YesNo6. Can we have your permission to post your comments on our website or promotional materials? No identifying information will be used - only your comments.YesNoNameEmail ZIP/Postal CodePhone Number
