Patient Survey

We are always striving to improve the care we provide. We would like to identify problems but also identify areas that we are doing well so we can acknowledge our staff. This form is anonymous. Please fill out the form as honestly as possible. Leave a question blank if it is not applicable to you. Thanks so much for helping us.
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    Access to Care

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    Your wait to see the doctor

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    Dr. Jacobs

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    Ancillary Services

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    Allergy shots

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    Personal Issues

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    Billing

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    Overall Assessment

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