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When your treatment program is completed, we would appreciate any comments that would help us improve patient care in the future.


1. Was the office environment pleasant and relaxing?
Yes Somewhat No

2. Was the waiting room comfortable with varied reading materials?
Yes Somewhat No

3. Was our staff courteous and helpful?
Yes Somewhat No

4. Were we reasonably prompt in starting treatment on most visits?
Yes Somewhat No

5. Was the doctor caring and gentle?
Yes Somewhat No

6. Were you kept informed of progress during the stages of treatment?
Yes Somewhat No

7. Are you satisfied with the results of the treatment?
Yes Somewhat No

8. Were the financial arrangements satisfactory to your family?
Yes Somewhat No

9. Were the financial matters explained clearly and properly from the beginning?
Yes Somewhat No

10. Would you recommend our practice to your friends?
Yes Somewhat No


11. Comments:



 



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