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PATIENT SATISFACTION SURVEY

CALL OR FAX

PH: (610) 925-3222
FAX: (610) 925-3180

VISIT

127 West Street Road, Suite 301
Kennett Square, PA  19348

OFFICE HOURS

Mon. – Thu. 8:00am – 5:00pm

We Would Love Your Feedback!

Patient Satisfaction Survey

We understand that each patient is unique and requires different levels of assistance. We aim to cater your experience to one that serves you the best! Let us know how we are doing by completing our patient satisfaction survey.

    *How would you rate your overall experience with our practice?

     

    Please rate the following (scale of 1 to 5, with 5 being best):

     

    Phone manners of our staff:

    12345

    Convenience of your appointment time:

    12345

    Greeting upon arrival:

    12345

    Helpfulness of our staff:

    12345

    Sensitivity and attentiveness of doctor and staff:

    12345

    Explanations provided/questions answered?:

    12345

    Do you feel positive enough about our practice to refer family and friends?

    YesNo

    Please comment on anything regarding our service that we might change to make your future experiences with us even more positive:

    Name (optional):

    *May we share your comments with others?

    YesNo

    *May we use your comments for future marketing materials?

    YesNo