First, tell us about yourself:
First Name*
Last Name*
Email Address*

Are you a patient of this Provider?
If no, what is your relation to the patient?
If yes, how long have you been a patient?
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Next, please rate Diya F Mutasim, MD:


Rate each question 1-10 Stars (10 Stars is Best, Leave Blank for Not Applicable)

1. How clean/sanitary was the office environment?
2. Were you seen in a timely manner?
3. Did this Provider explain your condition and treatment in a way that you could understand?
4. During this office visit, did this Provider spend enough time with you?
5. How would you rate this Provider's knowledge of your medical history?
6. Did this Provider or his/her staff encourage you to ask questions?
7. Does your Provider discuss exercise, weight loss, smoking cessation, stress management, or other illness preventive measures?
8. Did someone from your Provider's office follow-up to give you any test results within a reasonable amount of time?
9. Do you believe your health will improve following your Provider's instructions?
10. Did you feel as though the Provider's reception staff was as helpful as you thought they should be?
11. Did the Provider's Nurses and Medical Assistants treat you with courtesy and respect?
12. How likely would you be to recommend this Provider to others?
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