Patient Satisfaction Survey

    The comfort/atmosphere of the office and exam rooms:
    PoorFairGoodVery GoodExcellent

    The thoroughness of the initial evaluation:
    PoorFairGoodVery GoodExcellent

    The adequacy of explanation of procedures:
    PoorFairGoodVery GoodExcellent

    The friendliness of your physician:
    PoorFairGoodVery GoodExcellent

    The friendliness of your receptionist:
    PoorFairGoodVery GoodExcellent

    The attention and respect to your privacy:
    PoorFairGoodVery GoodExcellent

    The attention given to what you had to say:
    PoorFairGoodVery GoodExcellent

    Your comfort in referring a friend or relative:
    PoorFairGoodVery GoodExcellent

    Your comfort in returning if you needed help again:
    PoorFairGoodVery GoodExcellent

    Additional Comments:

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