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This survey is anonymous and voluntary, we appreciate your feedback and even constructive criticism, but it is not mandatory. In no way will the care you receive from our team be changed based on whether or not you have completed a survey. However, if you have a particular concern about your provider, you will need to share those concerns directly with their office.

As part of our ongoing efforts to measure and improve the level of service provided by the team, we would appreciate you taking 5 minutes to complete our confidential patient survey.

Thank you.

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* 1. Who is your health care provider?

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* 2. In what year were you born? (use the slider or enter 4-digit birth year in the box on the right.)

1900 2025
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i We adjusted the number you entered based on the slider’s scale.

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* 3. What town do you currently live in?

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* 4. What is your gender?

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* 5. Do you feel comfortable and welcome at your health care providers office?

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* 6. Are you aware that some offices are using online appointment booking for non-urgent appointments?

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