# Clinic reception information survey

Clarify nonclinical reception arrangements.

If nothing was unclear or difficult, say so. Skip questions about steps you did not experience; use not applicable where appropriate.

## 1. Which arrival instruction was unclear?

Answer: ____________________

## 2. What waiting information was missing?

Answer: ____________________

## 3. Where did you seek assistance?

Answer: ____________________

## Author notes / illustrative keys where applicable

1. Read for arrival clarity. Keep the specific explanation in the respondent’s own words rather than converting it into an unexplained overall satisfaction score.
2. Read for waiting context. Keep the specific explanation in the respondent’s own words rather than converting it into an unexplained overall satisfaction score.
3. Read for help route. Keep the specific explanation in the respondent’s own words rather than converting it into an unexplained overall satisfaction score.

Interpretation caution: Exclude diagnoses and patient identifiers.