Patient Survey Please select the location of your most recent visit to our practice: Jupiter Wellington West Palm Beach Please select the provider you would like for surgery: Alan Pillersdorf, M.D. Alberto Navarro, M.D. Dov Eidelman, M.D. Ernesto Hayn, M.D What was the purpose of your visit? Consultation Office Visit Follow Up Procedure / Surgery When you called for an appointment, how would you rate the response from the person who answered the telephone? Very Good Good Average Fair Poor When you arrived at the office, was the receptionist ?Helpful Very Good Good Average Fair Poor Friendly Very Good Good Average Fair Poor How acceptable was the amount of time spent in the reception area and exam room, before seeing the doctor? Very Good Good Average Fair Poor When you were called to the treatment room, how would you rate our staff in terms of being?Friendly Very Good Good Average Fair Poor Competent and Professional Very Good Good Average Fair Poor Sympathetic and Caring Very Good Good Average Fair Poor During your examination, how would you rate the doctor in terms of being?Friendly Very Good Good Average Fair Poor Competent and Professional Very Good Good Average Fair Poor Sympathetic and Caring Very Good Good Average Fair Poor Please rate your satisfaction with the amount of time the doctor spent with you answering your questions, and explaining medical procedures and treatments. Very Good Good Average Fair Poor Not Applicable If you scheduled a procedure, please rate your satisfaction with the scheduling process. Very Good Good Average Fair Poor Not Applicable If a procedure was recommended, please rate your satisfaction with the manner in which the doctor discussed details and information regarding the need for the recommended procedure(s). Very Good Good Average Fair Poor Not Applicable If you had a procedure, please rate your satisfaction with your results. Very Good Good Average Fair Poor Not Applicable When discussing fees for your visit or procedure, how would you rate our staff in terms of being ?Friendly Very Good Good Average Fair Poor Helpful Very Good Good Average Fair Poor Did you find that visiting our office was a positive experience? A very positive experience A somewhat positive experience Neutral A somewhat negative experience A very negative experience If you had a less than positive experience, please explain further.Did you like the availability of cosmetic products in our office? Yes No Not Available Are you interested in any additional cosmetic services? Yes No Maybe Services of interest:Would you recommend our practice to your friends? Yes No Maybe Thank you for sharing your experience with us. Please add any additional comments below. Your input helps us improve our service.CAPTCHA
