Call Us: 561.753.7487 Home Our Doctors Doctors Jesse Eisenman, M.D. Richard Eisenman, M.D. Cathia Rene, M.D. The Facility Facilities Gastroenterology Advanced Surgery Center Patient Information Online Forms Appointments Patient Registration Prescription Refills Satisfaction Survey Printable Forms Bill Of RIghts & Responsibilities Consumer Assistance Notice Notice Of Privacy Practices Patient Registration Form Your Right to Privacy Insurance Helpful Information Helpful Information Colon Polyps Constipation Diverticular Disease GERD Contact Us Office Location 5065 South State Road 7 Suite 201 Lake Worth, Florida 33449 Office Hours Monday - Friday 8:00 - 5:00 EST Contact Information Phone: 561.753.7487 Fax: 561.753.8161 Directions Get directions to our office. Eisenman & Eisenman, M.D. Satisfaction Survey Survey Eisenman & EisenmanAdvanced Surgery Center Dr. Seen: * -- Select One -- Jesse Eisenman, M.D. Richard Eisenman, M.D. Cathia Rene, M.D.   Date Of Visit: *   (1) Did the receptionist meet and greet you in a cordial, friendly, helpful manner? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (2) Was the receptionist helpful in assisting you in explaining and filling out the necessary paperwork and courteously and respectfully explain your co-pay responsibilities? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (3) Did the medical assistant (the person who calls you from the waiting room into the patient exam room) introduce themselves by name and make you feel welcome and comfortable? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (4) Did the physician spend adequate time with you and answer all of your questions and treat you in a professional manner? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (5) Did the staff at the time of checkout carefully go over the procedure instructions and help you schedule tests you will be having and assist you in a concerned conscience manner? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (6) Did the checkout staff and/or business department clearly explain your financial responsibilities in a professional manner? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (7) Did you find any staff member particularly helpful and/or compassionate, in your case? (8) Did the nurse promptly return your phone calls, call in any prescription in a timely manner and spend the necessary time to instruct you on your care? Strongly AgreeAgreeDisagreeStrongly DisagreeN/A (9) What suggestions would you have to improve your visit? (10) How specifically did you hear of our practice? (11) Would you recommend our practice to a friend or family member? YesNo GENERAL HOME INSURANCE CONTACT US DIRECTIONS OUR DOCTORS JESSE EISENMAN, M.D. RICHARD EISENMAN, M.D. CATHIA RENE, M.D. THE FACILITY GASTROENTEROLOGY ADVANCED SURGERY CENTER ONLINE FORMS APPOINTMENTS PATIENT REGISTRATION PRESCRIPTION REFILLS SATISFACTION SURVEY PRINTABLE FORMS BILL OF RIGHTS & RESPONSIBILITIES CONSUMER ASSISTANCE NOTICE NOTICE OF PRIVACY PRACTICES PATIENT REGISTRATION FORM YOUR RIGHT TO PRIVACY HELPFUL INFORMATION COLON POLYPS CONSTIPATION DIVERTICULAR DISEASE GERD Copyright © 1990-2012 Eisenman & Eisenman, M.D., LLC. All rights reserved. Plans, specifications, pricing, locations and amenities are subject to change without notice. Privacy Policy  |  Terms Of Use

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