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Patient Feedback (Burkholder Wellness)
Thank you for choosing Burkholder Wellness for your healthcare needs!

We would love your patient feedback to see where we are doing well and where we can improve.

How satisfied were you with your over-all experience at Burkholder Wellness?
Not very satisfied
Very satisfied
How satisfied were you with how you were treated at Burkholder Wellness?
Not very satisfied
Very satisfied
How satisfied were you with the scheduling process?
Not very satisfied
Very satisfied
How satisfied were you with the wait time at your appointment?
Not very satisfied
Very satisfied
How satisfied were you with the actual time spent with your provider during your appointment?
Not very satisfied
Very satisfied
How satisfied were you with the actual diagnosis, medications, and the treatments ordered or recommended?
Not very satisfied
Very satisfied
Would you like to add any additional comments to your survey?
Your answer
In what ways can we improve our services?
Your answer
Would you like for us to use your survey and/or comments on our social media outlets (website, Facebook, Instagram)?
If "yes" to above question, would you like your name to appear with your comments? Or would you like to remain anonymous?
Would you like to record a video testimonial for our website and social media outlets?
First & last name (optional):
Your answer
Contact information (optional):
Your answer
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