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* 1. The professional and courteous service of the office staff was:

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* 2. The speed and efficiency of registration was:

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* 3. Answers to financial and insurance questions were:

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* 4. The professional and courteous service of the nurses was:

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* 5. The way the nurses introduced themselves and kept you informed was:

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* 6. Nurses explanations of the procedure were:

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* 7. Answers to questions you asked were:

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* 8. The written instructions for your home care were:

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* 9. The staff gave you the privacy you needed

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* 10. The cleanliness and comfort of the surgery center was:

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* 11. The likelihood that you would return or recommend the surgery center to others is:

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* 12. What is your overall rating of your experience at The Surgery Center?

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* 13. Please share any additional comments you may have:

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* 14. Would you like to be contacted about a concern with The Surgery Center?

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* 15. If you would like to be contacted, please provide the information below:

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