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1. Did you receive a telephone call from our automated system reminding you of your appointment?

2. Scheduling my appointment and check in were a pleasant experience.

3. The office staff and physicians were professional and courteous during my office visit.

4. How helpful was the staff in seeing to your specific needs?

5. How well were you educated on exams or testing performed during your visit?

6. How well did your physician address your specific needs during your office visit?

7. Overall, wait times experienced while in our office were:

8. Would you recommend our office to your family or friends?

9. What did you like best about your experience with our office?

10. If you have any recommendations for performance improvement, please provide them below.