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Please complete the Patient Satisfaction Survey below and add your name to the Comments section at the end of the survey to be eligible to win a month of free parking. Drawings will be done quarterly.

Free parking will be for the parking garage at UTPB Only. Results of this survey are kept confidential; providing your name is optional.

Patient Visit Experiences

During your appointment at our clinic, how satisfied were you with the following:

Receptionist/Office Personnel's:

Greeting/acknowledgement upon arrival


Willingness to answer questions

Staff Nurse's:


Willingness to answer questions

Quality of care provided to you



Willingness to answer questions

Time spent with you to address your concerns

Quality of care provided to you

Overall Clinic:


Quality of care provided to you

The amount of time you waited:

In the patient waiting area

In the exam room

Other Clinic Services

How satisfied are you with our:

Appointment scheduling:

Ability to schedule an appointment within a reasonable amount of time

Convenience for your schedule

Ability to schedule your urgent mental health needs

Clinic hours of operation

Other Clinic Services:

Before/after hours on call service

On-site Laboratory Services

On-site Pharmacy

Patient Classification

    Are you a:

Overall Rating

Would you recommend UTHealth Student Health Services to other UTHealth students?

I am confident that my personal health information will be treated with confidentiality.

How did you find out about Student Counseling Services?

Which ones of the following UTHealth mental health resources are you aware of? (multiple selection)

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