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1. What is your name? (Optional)

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2. When did you visit our practice?

Date

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3. Which practitioner did you see during your visit?

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4. Is this the practitioner you asked for while making your appointment? 

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5. Which office did you visit during your appointment? 

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6. How easy was it for you to schedule an appointment at our practice?

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7. How would you rate the overall care you received at our practice?

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8. How would you rate the Medical Assistant/Nurse?

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9. How would you rate our office staff?

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10. Is there any staff member you would like to comment about? (Example: Practitioner, MA, Operator)

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11. How satisfied were you with your wait time?

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12. How easy was it for you to obtain follow-up information? (Example: Blood Work/Test Results)

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13. Do you like the option of being able to text the office?

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14. What would you use text service for?

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15. How many years have you been visiting our practice?

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16. How likely would you be to recommend Dr. Scafuri & Associates to Friends and Family?

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

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17. Please leave a review/additional comments about your experience at Dr. Scafuri & Associates. 

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18. Would you be willing to allow us to feature your review on our site? If we use your review, we won't use your name, just your initials.

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