Customer Feedback

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Have you visited us before?
YesNo

To what extent do you agree or disagree with each of the following statements concerning your visit?

Service Rating

It was easy for me to get attended
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The waiting time was short
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

Staff Rating

The staff I interacted with were polite and respectful
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The doctor listened, answered my questions and spent enough time with me
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The doctor gave me clear explanations and instructions
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The nurses and medical assistants were attentive and caring
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The staff that assisted me with billing and insurance were helpful
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

Facility Rating

I found the hours of operation convenient
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The waiting room was comfortable and the facility was clean
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

Signage and directions were easy to follow
Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

Overall Rating

How would you rate our services?
ExcellentVery GoodGoodFairPoor

Would you recommend us to a friend or colleague?
YesNo

Any Additional Details