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* 1. Who did you see today?    A quien vio hoy?

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* 2. How easy or difficult was it to schedule your appointment at a time that was convenient for you?

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* 3. Overall, how satisfied or dissatisfied were you with your last visit to our office?  

En general que satisfecho se encuentra usted en su ultima visita en la clinica?

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* 4. Our nominal fee is $25.  Is this fee affordable?

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* 5. How likely is it that you would recommend IMAN to a friend or colleague?

Not at all likely
Extremely likely

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* 6. Do you have any other comments, questions, or concerns? 

Tiene usted alguna otro comentario, pregunta o preocupacion?

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* 7. How would you describe yourself

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* 8. Which evening during the week would you prefer to have evening hours

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* 9. Which weekend day would you prefer to seek medical care

T