Amae Plastic Surgery

Patient Survey

Thank you for choosing Âmae Plastic Surgery for your procedure. In an effort to provide the very best care to our patients and their families, we would appreciate it if you would spend a few minutes of your time completing this questionnaire. Thank you again for your comments.

Printable version of the survey is also available - patient survey.

Registration
Overall quality of your experience with registration
Length of time waiting in lobby
Comfort and cleanliness of lobby area and exam rooms

Office Staff
Kind and caring attitude of staff who registered you
Information given to you and your family
Staff accessibility by phone

Doctor
How did you feel about your consultation
Kindness and caring attitude of the doctor
Clear and complete explanations provided to you and your family
Your pain management level

Follow Up
Clear and complete instructions for your care at home
Clear and complete instructions for pain management at home
Follow up appointments scheduled promptly

Overall
Amount of dignity and respect shown to you
Overall quality of care and services
How would you recommend Âmae Plastic Surgery to your family and friends

Where did you hear about us?


How do you feel about the surgical results of your procedure?


What did we do well?


What could we do better?

Your First Name
Date of Procedure

We know you have many choices. Thank you for choosing us.

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Amae Plastic Surgery

Patient Survey

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