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WHSB Patient Experience Form 
We'd love to hear about your experience with our clinic! Your feedback helps us improve and allows future patients know what to expect. Please share as much as you're comfortable with. Some testimonials may be featured on our website or social media, with your permission.
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Please provide your first and last name or type "anonymous"
Which provider did you see during your visit?
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How would you describe your experience with our providers and staff?
Was there something special about your visit that stood out to you
If a friend asked why they should come to our practice, what would you tell them?
Is there a specific provider or staff member that you would like to recognize
Do you consent to have your testimonial shared on our social media pages
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If answered Yes above and do not wish to remain anonymous, please provide your contact information for us to obtain consent. 
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