Patient Satisfaction Survey
Answering these 5 questions will help us better serve you.
Sign in to Google to save your progress. Learn more
Visit Date *
MM
/
DD
/
YYYY
Which SCC locations did you attend? *
The waiting room was tidy, clean and comfortable. *
The Medical Lab Assistant who took my blood was courteous and professional. *
Did  you receive service within 35 minutes? *
How was your overall experience at this Specimen Collection Centre? *
Please share with us any comments that you may have about your visit, or anything we can do to improve our services.
Optional: Please enter your name and contact information
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report