Customer Service Survey
1
. Please rate the helpfulness of our staff
Please rate the helpfulness of our staff
Excellent
Good
Poor
Other
2
. How would you rate the quality of your visit?
How would you rate the quality of your visit?
Excellent
Good
Poor
Other
3
. Were you satisfied with your appointment?
Were you satisfied with your appointment?
Excellent
Good
Poor
Other
4
. How likely are you to refer us to a friend?
How likely are you to refer us to a friend?
Excellent
Good
Poor
5
. Please rate your overall experience.
Please rate your overall experience.
Excellent
Good
Poor
Other (please specify)
6
. Please rate the appearance of our office.
Please rate the appearance of our office.
Excellent
Good
Poor
Other
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