Patient Satisfaction Questionnaire

Patient Satisfaction Questionnaire

Thank you for choosing Berman Plastic Surgery & Spa. Your feedback helps us improve the quality of care and service we provide. Please take a few minutes to complete this confidential survey.
On a scale from 1 to 5, 1 being poor or unlikely and 5 being excellent or definitely, please rate us on the following questions.
1. How would you rate your appointment in addressing all your questions and concerns?

1

2

3

4

5

1 is Poor, 5 is Excellent
2. How would you rate the courtesy and professionalism of our staff?

1

2

3

4

5

1 is Poor, 5 is Excellent
3. How would you rate the information and guidance provided for your care and/or recovery?

1

2

3

4

5

1 is Poor, 5 is Excellent
4. How would you rate your overall experience at Berman Plastic Surgery and Spa?

1

2

3

4

5

1 is Poor, 5 is Excellent
5. How likely are you to recommend our plastic surgery services to others?

1

2

3

4

5

1 is Unlikely, 5 is Definitely
Final Thoughts & Feedback
6. Additional comments:
Calculated Average Satisfaction Rating
Should be Empty: