Patient Survey Your Full Name Your Email 1. How would you rate your doctor’s performance (1 worst- 5 best)? 12345 2. Was your doctor professional and considerate? (1 worst- 5 best)? 12345 3. Did your doctor answer all of your questions? (1 worst- 5 best)? 12345 4. How was the appointment session? (1 worst- 5 best)? 12345 5. How knowledgeable was your doctor about your issue? (1 worst- 5 best)? 12345 Δ
