The quality of your care is our first concern. To help us continually improve our service, please take a moment to give us your feedback. We only use this information internally and would never share with outside parties.

How would you rate your overall experience with Kelly Plastic Surgery?

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Please rate the following (scale of 1 to 5, with 5 being best):

Telephone demeanor: Were the staff polite and courteous on the phone?

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Convenience of appointment: Did we schedule you promptly?

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Were the staff courteous and professional during every aspect of your visit?

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Were all your questions/concerns addressed thoroughly and to your satisfaction?

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How would you rate the sensitivity and attentiveness of the Doctor?

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How would you rate your overall experience with our practice?

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Are you aware that our practice is accepting new patients?

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Do you feel positive enough about our service to refer family and friends?

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If no, would you allow us to contact you?

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What did you like about our services?

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Please comment on anything regarding our service that we might change to make future patient experience even more positive.

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Please give us your personal comments or testimonials.

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Your Name (optional)

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May we share your comments with others?

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If so, how would you like your name to appear First Name Last initial (Kate B.) or First and Last initial (KB)?

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Thank you for your time!