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Patient Satisfaction Survey
Thank you for taking part in this feedback
1.
How would you rate the communication with our healthcare team?
Excellent
Good
Fair
Poor
2.
How would you rate the professionalism of our staff?
Excellent
Good
Fair
Poor
*
3.
Overall, how satisfied are you with your experience at our facility?
(Required.)
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Other (please specify)
4.
Do you feel safe during your visits to our facility?
Always
Most of the time
Sometimes
Never
5.
How would you rate the cleanliness of our environment?
Very Clean
Clean
Somewhat Clean
Not Clean
6.
Is the communication about your condition and treatment clear?
Very Clear
Clear
Somewhat Clear
Not Clear
7.
Do you feel that you understand your condition and the aim of your treatment?
Completely
Mostly
Somewhat
Not at all
8.
Do you feel heard and understood by our staff?
Always
Most of the time
Sometimes
Never
9.
What else could we do to improve your experience?
10.
What was the best part of your time with us?