The Woods Crew really wants to know…

How do you feel about us?

 

Your Name (required)

Your Email (required)

Daytime Phone (required)

In terms of your satisfaction, how would you rate us for the following?

Please select an appropriate rating for the questions below:

1) Were you able to make an appointment in a timely fashion?

 Excellent Very Good Good Fair Poor

2) Convenience of getting through to the office by phone.

 Excellent Very Good Good Fair Poor

3) The personal manner (courtesy, respect, sensitivity, friendliness) of the entire office staff.

 Excellent Very Good Good Fair Poor

4) Did the clinician answer all of your questions?

 Excellent Very Good Good Fair Poor

5) Would you recommend our practice to your family and friends?

 Excellent Very Good Good Fair Poor

6) Overall Rating (For this particular visit):

 Excellent Very Good Good Fair Poor

7) In your own words, please share with us what you think about us?

8) Are there any other suggestions that would improve our services to you?

9) May we publish your results on our web page?

 YES NO

PLEASE NOTE: For Privacy reasons your real (full) name will not be used on the website, if you choose to have your testimonial published. Instead, we will use your Initials.

However, if you wish to use a particular "Alias" or wish for your testimonial to be completely "Anonymous" then please enter the alias of your choice below:

Thank you kindly for your participation.

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