Clinic Survey

Clinic Survey

Initial Contact Availability:

Please respond to the statements below on a scale of 1-5 where 1 means "Strongly Disagree" and 5 means "Strongly Agree."

Your Visits and Quality of Care:

Please respond to the statements below on a scale of 1-5 where 1 means "Strongly Disagree" and 5 means "Strongly Agree."

Our Facility:

Please respond to the statements below on a scale of 1-5 where 1 means "Strongly Disagree" and 5 means "Strongly Agree."

Your overall satisfaction:

Please respond to the statements below on a scale of 1-5 where 1 means "Strongly Disagree" and 5 means "Strongly Agree."
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