Feedback Survey The office I usually visit for my care is:*ClearwaterCountrysideDunedinFacial Aesthetics Center (FAC)LargoPort RicheySt. PetersburgWestchaseTrinityThe office staff's courtesy, friendliness, and respect for me are usually:*ExcellentGoodBelow AveragePoorEfforts by the office staff to get me to the doctor on time are:*ExcellentGoodBelow AveragePoorMy doctor's thoroughness and concern for me are:*ExcellentGoodBelow AveragePoorMy doctor's courtesy, friendliness, and respect for me are usually:*ExcellentGoodBelow AveragePoorThe amount and quality of time I spend with the doctor is:*ExcellentGoodBelow AveragePoorExplanations of my medical care by the doctor and his staff are usually:*ExcellentGoodBelow AveragePoorMy overall satisfaction with the quality of my care is:*ExcellentGoodBelow AveragePoorMy usual doctor/service is (please check all applicable):Dr. AldinaDr. BarnaDr. CohenDr. GreeneDr. HoodDr. MallonDr. MillerDr. MerchantDr. MorganDr. MullerDr. PateDr. SteinigerAllergyAudiologyOptional InformationAll information will remain private.Name First Last PhoneEmail Comments
Name*Email Phone*CommentsFor appointment scheduling only. Please DO NOT submit medical questions or general correspondence.