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* 1. Do you have Medicaid?

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* 2. Do you use public transportation for your office visits?

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* 3. If always or sometimes, please select the type of transportation. 

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* 4. Based on your experience how likely is it that you would recommend AxessPointe to your friends, family, or colleagues?

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* 5. Please tell us why you gave us that score.

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* 6. Please tell us how we can improve your experience at AxessPointe

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* 7. Contact Information (Optional)

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