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Patient satisfaction surveys are widely used to measure patients’ opinions of the quality of the health care they have received. There are a variety of methods for distributing patient satisfaction surveys. Different distribution methods may yield significantly different satisfaction ratings.We sought to compare survey ratings obtained via 2 distribution methods: handout versus mailed.Patients were randomized to receive either a handout survey or a mailed survey.Patients who had an appointment with a family practice provider in one of the regional outpatient centers of a large medical clinic during a 3-week period.An 11-item visit-specific patient satisfaction survey was used to survey patient satisfaction.Handout surveys yielded higher satisfaction scores than mailed surveys. The response rate was higher with handout surveys than with mailed surveys. However, handout surveys were returned with more skipped questions, a lower variation in ratings, and fewer written comments than the mailed surveys.Both quantitative and qualitative differences between the 2 distribution methods were revealed. Attempts to compare data obtained from the 2 different distribution methods need to be approached with caution.