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Post-Visit Patient Experience Survey
1.
How satisfied were you with your overall experience with Goal Pediatric Orthotics?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
2.
Did the provider listen to your concerns and address them adequately?
Yes, completely
Mostly
Somewhat
Not really
Not at all
3.
How likely are you to recommend Goal Pediatric Orthotics to other families?
Very Likely
Likely
Nuetral
Unlikely
Very unliekely
4.
How satisfied were you with the explanation of insurances coverage and cost?
Very Satisfied
Satsified
Nuetral
Dissatisfied
Very unsatisfied
5.
How easy was it to schedule your appointment?
Very easy
Somewhat easy
Neutral
Somewhat difficult
Very difficult
6.
Were instructions for care, wear and maintenance explained clearly and do you feel confident using the equipment after your appointment?
Yes
No
Not sure
7.
Please provide any additional comments or suggestions you may have regarding your visit.