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Waldorf, MD:301-645-5410
California, MD:301-862-7550
Center For Advanced Orthopedics and Sports Medicine A Division of Centers for Advanced Orthopedics, LLC

Patient Satisfaction Survey Form: Center for Advanced Orthopedic

Office Location
Physician:n
Date of Service:

Our goal is to provide you with a positive patient experience and the best orthopedic service available. We value your opinion. Please complete the questionnaire and leave it in the Suggestion Box at the front desk.

Excellent Good Average Poor N/A

1. Ease of making an appointment when calling by phone.
 
2. Availability of appointment within a reasonable time frame.
 
3. How satisfied were you with the manner in which you were treated by the following:
 
a) Telephone Receptionist
b) Front Desk Receptionist
c) Billing Specialist
d) Surgical Coordinator
e) Physician
 
4. How would you rate the facility:
 
a) Cleanliness of facility
b) Staff response to inquiries
c) Physicians answers to questions
 
5. Please rate your overall experience at our office.
 
6. How did you hear about us?






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