[]\n \n \n 1\n Step 1\n \n \n \n \n \n \n \n \n \n \n \n \n How would you rate our communication service?\n \n \n AverageGoodExcellentAccessibility of Phone NumbersStaff’s courtesy and helpful nature over the phone and at our hospitalEasy scheduling your appointment\n \n \n How would you rate our administration?\n \n \n AverageGoodExcellentEfficiency of registration procedureInformation provided regarding treatment and procedures\n \n \n How would you rate our medical care?\n \n \n AverageGoodExcellentCheckup by our optometristNurse’s assistanceDoctor’s explanation regarding treatment required by youConfidence in your doctor’s ability to diagnose and treat your conditionOverall experience of your visit\n \n \n YesNoWould you recommend our service ?\n \n \n Any other comments0 / \n \n \n Nameyour full name\n \n \n MRD NumberYour medical record number\n \n \n Submit Form\n \n \n \n \n \n \n Previous\n Next\n \n FormCraft - WordPress form builder
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