Your Feedback Matters!
At Vertex Pain Physicians and Omni Spine Care, we want our patients to have the best experience in treating their pain. Please take a moment and tell us about your visit, our services, our providers, or any other feedback you may have for us to make your experience even better!
Your Name (Optional):
First Name
Last Name
Email:
*
example@example.com
Date of appointment:
-
Month
-
Day
Year
Date
Which clinician(s) did you see?
*
Urfan A. Dar, M.D.
Sridhar Vasireddy, M.D.
Moez Mithani, M.D.
James Houston, PA
I am not sure who I saw.
Other
Which location(s) did you visit?
*
Stone Oak — 20079 Stone Oak Pkwy #1245, San Antonio, TX
Medical Center — 9130 Wurzbach Rd Ste 102, San Antonio, TX 78240
Southside — 102 Palo Alto Rd, San Antonio, TX 78211
Did you get enough time with the doctor?
Yes
No
Were you satisfied with your interactions with the office staff?
Yes
No
How Was Your Experience?
*
Please Select
10 (Very Good)
9
8
7
6
5
4
3
2
1 (Very Poor)
How Does Your Care And Treatment Compare With Your Expectations Regarding Each Item Below?
Great
Better Than Expected
Average
Worse Than Expected
Poor
Treatment From Medical Provider
Patient Care During Exam And/Or Procedure
Customer Service When Arriving At Clinic
Customer Service When Scheduling Appointment
Ease Of Appointment Scheduling
How Would You Rate Your Wait Time?
How Was The Cleanliness And Ambiance Of The Office?
How Efficient And Comprehensive Was The Billing Process?
How Likely Are You To Recommend Our Office To A Friend Or Colleague?
Please Select
5 - Definitely Will Recommend
4 - Somewhat Likely
3 - Neither Likely Nor Unlikely
2 - Somewhat Unlikely
1 - Definitely Will Not Recommend
What are we doing right? What can we do better?
May we use your comments online for quality improvement and marketing?
*
Please Select
Yes
No
Please verify that you are human
*
Submit
Should be Empty: