Patient Feedback Survey

Patient Feedback Survey

Thank you for doing this survey!
We are interested in you honest opinions so that we can continue to improve our customer support.
1. Overall, how satisfied were you with the experience in our clinic today? *

Extremely satisfied Very satisfied Somewhat satisfied Not so satisfied Not at all satisfied
2. How knowledgeable was the clinician who treated you today? *

Extremely knowledgeable Very knowledgeable Somewhat knowledgeable Not so knowledgeable Not at all knowledgeable
3. How was the communication between the clinician and yourself today? *

Excellent communication Very good communication Some communication (could be improved) No communication
4. How much time did it take us to provide you with your treatments today? *

Much shorted than expected Shorter than expected About what I expected Longer than expected Much longer than expected
5. Was the treatment you received today to your satisfaction? *

YES NO
6. Is there anything else that you think would improve our service?

7. How likely is it that you would recommend Freshfaced to a friend or colleague? *

	1	2	3	4	5	6	7	8	9	10

1 is Not at all likely, 10 is Extremely likely