Which of our offices did you visit?

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* 1. Which of our offices did you visit?

Was this your first visit to Waterbury Pulmonary?

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* 2. Was this your first visit to Waterbury Pulmonary?

If you were tested during your visit, what kinds of tests were preformed?

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* 3. If you were tested during your visit, what kinds of tests were preformed?

Please rate your satisfaction regarding the amount of time you waited in the waiting room, assuming that you arrived at your scheduled appointment time.

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* 4. Please rate your satisfaction regarding the amount of time you waited in the waiting room, assuming that you arrived at your scheduled appointment time.

How long did you spend in our waiting room before being called in for your appointment?

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* 5. How long did you spend in our waiting room before being called in for your appointment?

Please rate your satisfaction with:

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* 6. Please rate your satisfaction with:

  Excellent Good Fair Poor N/A
Our reception staff:
Our reception and registration process:
Our technologist (the person performing your exam)
How did your hear about us?

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* 7. How did your hear about us?

Would you recommend us to a friend or family member?

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

How could we improve today's experience?

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* 9. How could we improve today's experience?

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