Puyallup Dermatology Visit Survey Question Title * 1. How long has it been since your most recent visit with Puyallup Dermatology? Less than 1 month At least 1 month but less than 3 months At least 3 months but less than 6 months At least 6 months but less than 12 months 12 months or more Question Title * 2. During your most recent visit, did your dermatologist listen carefully to you? Yes, definitely Yes, somewhat No Question Title * 3. During your most recent visit, did your dermatologist show respect for what you had to say? Yes, definitely Yes, somewhat No Question Title * 4. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate Puyallup Dermatology? 10 Best provider possible 9 8 7 6 5 4 3 2 1 0 Worst provider possible . . 10 Best provider possible . 9 . 8 . 7 . 6 . 5 . 4 . 3 . 2 . 1 . 0 Worst provider possible Question Title * 5. Would you recommend Puyallup Dermatology’s office to your family and friends? Yes, definitely Yes, somewhat No Question Title * 6. During your most recent visit, were clerks and receptionists at Puyallup Dermatology’s office as helpful as you thought they should be? Yes, definitely Yes, somewhat No Question Title * 7. During your most recent visit, did clerks and receptionists at Puyallup Dermatology’s office treat you with courtesy and respect? Yes, definitely Yes, somewhat No Question Title * 8. What is your age? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 9. Are you male or female? Male Female Done