Patient/Parent Questionnaire

We have enjoyed working with you thus far and would appreciate your help in making our relationship as productive as possible. Please answer the questions below so that we can see our treatment from your point of view.
 

Are you in general pleased with the manner in which we've treated you personally? Please comment:		Yes		No
Is treatment progressing as you anticipated? Please comment:		Yes		No
If you called with an emergency, was the receptionist understanding and helpful?		Yes		No
Were you appointed within a reasonable length of time? Please comment:		Yes		No
Please note the things you LIKE about our practice:
Please note the things you feel COULD BE IMPROVED in our practice:
Name (optional):

Thank you for taking the time to let us know how we are doing.