Survey

Full Name

Which doctor attended to you?

How would you rate us in medical terms?

Excellent: The treatment I received fully met my expectations, and I am very satisfied with the results.
Good: The treatment was generally satisfactory, but there were some aspects that could be improved.
Fair: I experienced some concerns or dissatisfaction during the treatment.
Poor: The treatment did not meet my expectations, and I am dissatisfied with the results obtained.

How would you rate our customer service?

Excellent: The staff was extremely friendly, attentive, and helpful at all times.
Good: In general, I received adequate care, though there were some areas that could be improved.
Fair: There were aspects of the customer service that left me dissatisfied or unhappy.
Poor: The customer service was deficient and did not meet my expectations.

What do you think about the image of our clinic?

Professional and attractive: The clinic has a modern and professional appearance that conveys confidence.
Acceptable: The clinic’s image is acceptable, but it could be improved to provide a more pleasant experience.
Poor: The clinic’s image is unattractive or neglected, which negatively affects my perception.

How would you rate the cleanliness of our facilities?

Impeccable: The facilities were impeccably clean and well-maintained.
Acceptable: In general, the facilities were clean, but I noticed some details that could be improved.
Needs improvement: The cleanliness of the facilities did not meet my expectations and could be significantly improved.

How would you describe the treatment received by our staff?

Friendly and courteous: The staff was extremely friendly, courteous, and concerned about my well-being.
Professional but distant: While the treatment was professional, I felt a lack of warmth in the interaction with the staff.
Unfriendly or brusque: I experienced unfriendly or brusque treatment from the staff, which affected my experience at the clinic.

What has been your overall experience in our clinic?

Very satisfying: My experience in the clinic was excellent in all aspects, and I am completely satisfied.
Acceptable: In general, my experience was satisfactory, although there were some aspects that could be improved.
Unsatisfactory: I experienced various problems or dissatisfaction during my visit to the clinic, which negatively affected my experience.

Would you recommend us to family or friends?

Yes: I would definitely recommend your clinic to family or friends based on my positive experience.
No: I would not recommend your clinic to family or friends due to my negative experiences.
Maybe: I am undecided or need more time to consider whether I would recommend your clinic.

Is there anyone on the team you would like to commend?

Is there anything you believe we should improve or implement?

Is there anything else you would like to share about your experience with us?

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