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Patient Survey
It was easy to schedule an appointment at a convenient time.
Yes
No
The staff was courteous, friendly, and helpful.
Yes
No
I was satisfied with the quality of the services and products I received.
Yes
No
I would recommend your office to my family and friends.
Yes
No
Please make specific comments about the staff or doctors here.
May we use your comments as a testimonials?
*
Yes
No
What improvements do we need to make?
Name (optional)