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Our office is dedicated to achieving complete patient satisfaction. Kindly fill out this short survey to assist us in providing you the best possible care.

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1. The staff was friendly and helpful.
 

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Neither Agree Nor Disagree
Disagree
Strongly Disagree

2. I was seen in a timely manner.
 

Strongly Agree
Agree
Neither Agree Nor Disagree
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Strongly Disagree

3. I received accurate information regarding my treament/surgery.
 

Strongly Agree
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Strongly Disagree

4. The staff explained treatments in terms I could understand.
 

Strongly Agree
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Strongly Disagree

5. The provider was knowledgable in their area of his/her specialty.
 

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Neither Agree Nor Disagree
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Strongly Disagree

6. The staff maintained my privacy.
 

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Strongly Disagree

7. The provider spent an appropriate amount of time with me.
 

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Neither Agree Nor Disagree
Disagree
Strongly Disagree

8. This office provides good care.
 

Strongly Agree
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Neither Agree Nor Disagree
Disagree
Strongly Disagree

9. I will return to this office if I am interested in another treatment/surgery.
 

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10. I would refer my family/friends to this office.
 

Strongly Agree
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Strongly Disagree


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