We are dedicated to your lung health Specializing in Pulmonary Function Testing and Patient Consultation Customer Survey Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Date of Visit *1. Please rate your overall experience with your visit today *ExcellentGoodSatisfactoryNot very goodPoor2. If you had testing done at the clinic today, was there a long wait? *ExcellentGoodSatisfactoryNot very goodPoorSpecify:3. Was there a long wait to be seen by the doctor? *ExcellentGoodSatisfactoryNot very goodPoorSpecify:4. Was everything explained clearly? *ExcellentGoodSatisfactoryNot very goodPoorIf NOT SATISFACTORY, please explain:5. Were you treated with courtesy and care? *ExcellentGoodSatisfactoryNot very goodPoorIf NOT SATISFACTORY, please explain:6. Was the waiting room comfortable? *ExcellentGoodSatisfactoryNot very goodPoor NOT NOT please If NOT SATISFACTORY, please explain:7. Was the waiting room clean? *ExcellentGoodSatisfactoryNot very goodPoorIf NOT SATISFACTORY, please explain:8. Was the testing area clean? *ExcellentGoodSatisfactoryNot very goodPoorIf NOT SATISFACTORY, please explain:9. How satisfied were you with the front staff? *ExcellentGoodSatisfactoryNot very goodPoorPlease explain:10. How satisfied were you with the individual doing the testing? *ExcellentGoodSatisfactoryNot very goodPoorPlease explain:11. What can we do better to assist you?Comment's Box:Submit
