* 1. How likely is it that you would recommend this company to a friend or colleague?

Not at all likely
Extremely likely

* 2. Overall, how satisfied or dissatisfied are you with our company?

* 3. How would you rate the quality of the service?

* 4. How would you rate the value of care?

* 5. How responsive have we been to your questions or concerns?

* 6. How long have you been a patient?

* 7. How likely are you to use our practice again?

* 8. Do you have any other comments, questions, or concerns?