Feedback

How Easy Was it to Schedule Your Appointment?

Easy

Difficult

Very Difficult

When you need to speak with someone at our office, how easy is it for you to get to the right person?

Easy

Difficult

Very Difficult

How was the Doctor/Provider you met with?

Excellent!

Average

Not Good / Bad Experience

How was the staff at the facility?

Excellent!

Average

Not Good / Bad Experience

How would you rate the cleansliness of the office?

Very Good

Average

Not Good / Needs Work

Do you feel the provider/medical staff answered all of your questions and explained things clearly?

Yes

No

Other (Please leave notes below)

Did your appointment start on time?

Started Early

On Time

Late (Please tell us how late below)

How would you rate the overall experience at our office?

Excellent!

Average

Not Good / Bad Experience

Phoenician