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* 1. Your Full Name

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* 2. Your Email Address

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* 3. What was the date of your appointment?

Date / Time

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* 4. Which provider did you see?

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* 5. Would you recommend Houston Pulmonary, Sleep, and Allergy Associates to a friend or family member?

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* 6. Why would you not recommend Houston Pulmonary, Sleep & Allergy Associates?

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* 7. Why would you recommend Houston Pulmonary, Sleep & Allergy Associates?

T