2013 SOUTHEAST PATIENT SATISFACTION SURVEY

1.

 
We'd like to ask you some questions to help us provide the best possible health care for you. Your answers are completely confidential and voluntary. Thank you.
1. Gender:
2. What is your age?
3. What is your race/ethnicity?
4. Do you have health insurance (Aetna, Blue Cross, Medicaid, etc.)?
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