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First Name
Last Name
Phone Number
The Staff Was Efficient & Courteous on Phone *
I was able to Schedule My Appointment in an Acceptable Time Frame *
I was treated with Respect by the Medical Staff *
The Doctor Spent Sufficient Time With Me *
The Doctor Addressed All Of My Concerns *
Was Able To Check Out Efficiently and Quickly *
I Was Able To Schedule a Follow Up Visit That was Convenient For Me  *
I Would Recommend Dr. Gonzalez or Dr. Ng to My Friends *
** Please note, this is not a secure email and patient medical information should not be sent using this form.
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