Appraisal Form
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Email *
Date visited the clinic *
MM
/
DD
/
YYYY
Branch visited *
How was our service? *
Rate your experience with our Doctor. *
Name of the Doctor
Rate the Customer Service Representative’s Efficacy *
Name of the  Customer Service Representative.
How did you get to know about Cypress Eye Centre? *
If referred by a friend what's the name of the person? *
How easy was it to schedule an appointment with us? *
How likely are you to refer a friend, colleague or family member to our clinic? *
What did you like best about our service? *
What are the areas you suggest we should improve upon? *
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