Patient Satisfaction Survey

Question 1–5

How was your experience?

Five short questions. Your feedback helps us improve care.

Contact details

Optional — used only if you allow follow-up contact
1

How did you first contact / hear about us?

2

Overall, how would you rate the cleanliness of our clinic?

3

Were you informed before and after your treatment?

4

How likely are you to recommend us to others?

0 = not at all · 10 = extremely likely
0 10
5

Comments, suggestions or complaints