How Are We Doing?
We strive to provide the best experience for our patients and would appreciate your feedback.
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Date *
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DD
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YYYY
Name (optional)
Phone (optional)
What was your visit for? *
Overall, how would you rate your appointment with CARD? *
Poor
Excellent
If unsatisfactory please explain so that we can make improvements:
Overall, how would you rate the service you received from the staff during your visit? *
Poor
Excellent
If unsatisfactory please explain so that we can make improvements:
Is there anything we could have done to improve your visit today?
If your experience was particularly satisfactory, please explain below
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