* 1. Who was your provider today?

* 2. Do you feel your provider spent enough time with you, explained the issues at hand, and answered all questions?

* 3. Were you satisfied with the over all experience and presentation of the office, staff and providers?

* 5. Please rate the following stages of your DLCC experience.

  Poor Good Excellent Not Applicable
Ease and Convenience Scheduling
Check In Process
Wait Time to be Seen
Clinical Work Up
Check Out Process

* 6. Have you visited DLCC online?

* 7. Are you aware of our Clinical Research Department and the studies we offer?

* 8. Would you recommend this office to a family member or friend?

* 9. Tell us how great we did or let us know where there is room to improve! *If you would like to be contacted regarding your survey, please leave your name & telephone number below.

* 10. May we use your comment from Question 9 as a testimonial for marketing purposes (i.e. in our newsletter, on our Facebook page or website, etc.), displaying only your first name and age?