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Comments & Suggestions


Please take a moment to let us know how we are doing.  As a patient in our office, your satisfaction is important to us.  We welcome all of your comments and suggestions.  We CARE about you!

Is the receptionist friendly and courteous on the phone?

Yes
No
Comment:

When you come into our office, are you greeted in a friendly, warm manner?

Yes
No
Comment:

Do the Doctors take time to listen to your questions/concerns and understand your needs?

Yes
No
Comment:

Do the Doctors explain answers well for you?

Yes
No
Comment:

Do you find the office furnishings comfortable and inviting?  If no please explain.

Yes
No
Comment:

Have your billing questions/concerns been addressed properly and to your satisfaction?

Yes
No
Comment:

Is there any one thing you particularly like or dislike about your experience or care at our clinic?

Comment: 

Have you referred others to us for care?

Yes
No
Comment:

Is there anyone you would like to refer to our clinic?  One of your friends or loved one?

Yes
No
Comment:

Please share any ideas with us, so that we may improve our service to you in any way.

(Optional) Tell us how we may get in touch with you:

Name
E-mail
Tel
FAX

Thank you for taking the time to share your thoughts!




 

 

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