Question Title

* 1. How was the customer service when you called us on the phone?

 
Excellent
Very Good
Good
Fair
Poor
I didn't call

Question Title

* 2. How was the customer service of the front desk receptionist when you got there?

 
Excellent
Very Good
Good
Fair
Poor

Question Title

* 3. How quickly were you registered?

 
Excellent
Very Good
Good
Fair
Poor

Question Title

* 4. How did you find your waiting period?

 
Excellent
Very Good
Good
Fair
Poor

Question Title

* 5. How long was your wait?

Question Title

* 6. How would you rate the nursing staff?

 
Excellent
Very Good
Good
Fair
Poor

Question Title

* 7. How would you rate the doctor?

 
Excellent
Very Good
Good
Fair
Poor

Question Title

* 8. What is your overall satisfaction with our clinic?

 
Excellent
Very Good
Good
Fair
Poor

Question Title

* 9. What day and time did you visit us last?

Date
Time

T