Clinical Evaluation Feedback
Please provide your feedback on the clinical evaluation session to help us improve our processes and training.
Full Name
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First Name
Last Name
Date of appointment
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Month
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Day
Year
Date
Please rate the following aspects of the clinical evaluation:
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Rows
Poor
Fair
Good
Very Good
Excellent
Not Applicable
How informative was the sonographer?
How clean and tidy was the Clinic?
What was the waiting time like at your appointment?
What service package did you receive?
How did you hear about Womb With A View?
How would you rate the friendliness and professionalism of our staff?
How satisfied were you with the quality of the images?
Overall, how satisfied are you with the clinical evaluation experience?
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Please share any additional comments or suggestions for improvement.
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