Wufoo
Patient Questionnaire
We take great pride in offering the best experience possible at our practice. We are constantly striving to improve the service we provide. To help us do this we need your opinion about our performance from your last visit. We would greatly appreciate it if you could complete this anonymous form.
0%
Percentage complete
Do you find our receptionists courteous and helpful?
*
All of the time
Most of the time
Some of the time
Never/ hardly ever
Did the receptionist deal with you promptly?
*
Yes
No
Is the reception area clean and tidy?
*
Yes, it is always tidy
Sometimes tidy
Never tidy
Were you seen on time?
*
Yes
No
1
/
3
Do Not Fill This Out