Patient Experience Feedback Form Thank you for visiting our clinic. Your feedback helps us improve our services. Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. would waiting the How would you rate your overall experience today? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorDid the doctor address your concerns and explain clearly? *Yes, completelyPartiallyNoHow would you rate the courtesy and professionalism of our staff (reception / nurse)? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorHow satisfied were you with the waiting time before your consultation? *Very ShortAcceptableToo longDo you have any suggestions to help us improve our services?Submit
