During your visit to our office, was our staff courteous and helpful? Yes No Front Desk Personnel were: Excellent Best Average Poor Patient Coordinator was: Excellent Best Average Poor Who was your Patient Coordinator? Was accreditation of the facility important to you? Yes No How would you rate the cleanliness and hygiene at our medical facility? Excellent Best Average Poor How would you rate the amount of time a doctor spent with you? Excellent Best Average Poor Was your consultation educational and helpful in understanding the surgery to be done? Yes No Were all of your questions answered? Yes No Does your surgeon make you feel welcome and at ease? Yes No Did you have any issues arranging an appointment? Yes No If Yes, please explain below Did you consider another plastic surgery office? Yes No If Yes, Why did you choose our office instead of another? What did you like most about your consultation experience? What did you like least about your consultation experience? How can we improve it for future patients? Please list any general comments, suggestions, or employees who provided exceptional service: Email Address: *
