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Briz Brain & Spine Patient Feedback Survey

1.Which Doctor did you see?(Required.)
2.Was your appointment 'face-to-face' or over Skype/phone?(Required.)
3.Which site did you visit?(Required.)
4.Was this your first visit?(Required.)
How would you rate the following?
5.Ease in getting through to us by phone.(Required.)
6.Courtesy of staff taking your call.(Required.)
7.What was the length of time between making the appointment and seeing the specialist?(Required.)
8.The waiting room and amenities were clean and presented well.(Required.)
9.How long did you have to wait to see the doctor?(Required.)
10.Doctor's personal manner (courtesy, respect, sensitivity).(Required.)
11.Enough time and comfort to ask questions.(Required.)
12.Doctor's instruction regarding care and treatment.(Required.)
13.Did you book a procedure or surgery following your initial consultation(s) with your specialist?(Required.)
14.If you booked a procedure or surgery, were you satisfied with the bookings process?
15.Likelihood that you would recommend us to a friend or relative, should they require our services:(Required.)
16.How did you hear about us?(Required.)
17.Did you visit our website to gain further information?(Required.)
18.If yes, was it before or after your consultation?
19.From time to time we contact our patients to discuss their experience with us. Do you mind if we contact you?(Required.)
20.Which category below includes the age of the patient?(Required.)
21.Any comments?
22.Please enter your email address if you would like to be added to our mailing list.