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Post-Consultation Survey
Post-Consultation Survey
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How likely is it that you would recommend our office to a friend or family member?
1 (I would not)
2 (unlikely)
3 (not sure)
4 (likely)
5 (highly likely)
How satisfied were you with your consultation?
1 (very unsatisfied)
2 (unsatisfied)
3 (not sure)
4 (satisfied)
5 (very satisfied)
How would you rate the service you received from the staff at our office?
1 (very poor)
2 (poor)
3 (indifferent)
4 (good)
5 (excellent)
Did you feel comfortable in the lobby and waiting area?
Yes
No
How well did the Doctor listen to your needs and answer your questions?
1 (very poorly)
2 (poorly)
3 (adequately)
4 (well)
5 (very well)
How satisfied are you with the amount of time the Doctor spent with you?
1 (very unsatisfied)
2 (unsatisfied)
3 (indifferent)
4 (satisfied)
5 (very satisfied)
Which Doctor did you see?
*
Dr. Michael Pan
Dr. Manu Gujrati
Dr. Parsa Mohebi
Are you ready to book your Hair Transplant Procedure?
Yes
No
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