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Lexington, KY Ketamine Infusion Therapy Doctor
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HOME
ABOUT US
Lexington, KY Ketamine Infusion Therapy Doctor
TELEHEALTH
VIDEOS
MEETINGS
NA MEETINGS
AA MEETINGS
BLOG
CONTACT US
Top
PATIENT SATISFACTION SURVEY
Your Name
*
First
Last
Your Email
Your Medical Provider's Name
*
First
Last
Were we able to sufficiently help remind you of your appointment?
*
Yes
No
How easy or difficult was scheduling your appointment?
*
Very Easy
Easy
Difficult
Very Difficult
How was the timing of when you were seen compared to your scheduled appointment time?
*
Very Early
Early
On Time
Late
Very Late
Please rate your satisfaction with the following aspects of your visit:
*
Very Satisfied
Satisfied
Unsatisfied
Very Unsatisfied
The overall visit experience
The service you received from our staff members
The comfort of our waiting area
The cleanliness of our office
The amount of time your medical provider spent with you
Please answer the following questions regarding your interaction with your medical provider:
*
Very Well
Somewhat Well
Very Little
Not At All
How well did your provider listen to your concerns?
How well did your provider explain your treatment options?
How well did your provider explain your follow-up instructions? How well did your provider explain your follow-up instructions? (Very Well)
Overall, how would you rate the service you received from your medical provider?
*
Great
Good
Okay
Poor
Overall, how would you rate the trustworthiness of the medical advice you received?
*
Very Trustworthy
Trustworthy
Untrustworthy
Very Untrustworthy
How likely are you to recommend our office to a friend or family member?
*
Very likely
Likely
Unlikely
Very Unlikely
What other feedback do you have from your visit that could help us improve your experience next time?
*