Evaluate Your Visit

dd/mm/yy
Please rate the following areas related to your visit according to the following scale:

Poor - 0 1 2 3 4 5 6 7 8 9 10 - Excellent
N/A = not applicable
Quality of service received from the Front Desk Personnel.
Quality of service received from the Therapist.
Time waiting from entering into the office and being taken in by the therapist. In minutes.
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