Bardmoor | Clearwater | Palm Harbor
Safety Harbor | St. Petersburg | Trinity
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    Patient Satisfaction Report Card

    We want to provide the best quality medical care possible. To do that, we need your feedback to help us improve. Please complete this form and send it by clicking the submit button below.

    How did you first hear of us?

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    Level of Satisfaction
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    The doctor's explanation of your medical problem
    The amount of time the doctor spent with you
    The doctor's genuine concern for you and your problem
    The ease of making an appointment

    The friendliness and courtesy shown by the front
    office staff

    Amount of time you spent in the office waiting to be seen
    Convenience of office location
    How phone calls are handled
    The overall care provided to you

    How likely would you be to recommend the clinic to a friend?


    Do you think our clinic is the best place to go compared to other clinics
    in the area?


    What is your age?


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    Thank you for the privilege of caring for you.

     

     

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