Please Rate The Cleanliness And Appearance Of The Office?
Ease Of Getting Checked In, Including The Amount Of Time It Took?
Courtesy And Respect You Were Given By Provider: Friendliness And Kindness?
At The End Of The Appointment, How Clearly Were You Told What To Do And Expect?
Responsiveness To Telephone Inquiries?
Attention To Payment Issues?
If you received a referral, how clearly were you told what to do and what to expect?
Where Did You Hear About Us?
Optional. If You Would Like Us To Contact You, Please Fill Out This Portion Of The Survey:
Please enter the letters as exactly shown to the right and press the Send! button.