Shroff Eye Feedback Form

Shroff Eye Feedback Form

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How would you rate our communication service?

AverageGoodExcellent
Accessibility of Phone Numbers
Staff’s courtesy and helpful nature over the phone and at our hospital
Easy scheduling your appointment

How would you rate our administration?

AverageGoodExcellent
Efficiency of registration procedure
Information provided regarding treatment and procedures

How would you rate our medical care?

AverageGoodExcellent
Checkup by our optometrist
Nurse’s assistance
Doctor’s explanation regarding treatment required by you
Confidence in your doctor’s ability to diagnose and treat your condition
Overall experience of your visit
YesNo
Would you recommend our service ?
Any other comments
0 /
Nameyour full name
MRD NumberYour medical record number
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