Contact information
Patient Review Form
Email address *
Name *
Are you happy with our appointment system and how much you waited before you saw your doctor?
Address *
Date of visit
MM
/
DD
/
YYYY
Was the reception staff courteous and made you comfortable while you waited?
Did the doctor gave you enough time for explaining your problem?
Are you happy with the treatment received?
Was the endoscopic procedure or eye operation explained well in advanced?
Any suggestions?
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