Please describe the purpose of your visit:

Were you greeted in a friendly and professional manner upon arrival?:

How would you rate the cleanliness of our facility?:

How long did you have to wait beyond your appointment time before seeing a healthcare provider?:

Please rate your satisfaction with the healthcare provider you saw:

What was the primary reason for your dissatisfaction? Please select all that apply

Please provide more details about your experience or how we can improve our service:

Would you consider returning to All Day Medical Care in the future?

May we contact you to discuss your experience in more detail?