Patient Survey


    On a scale of 1-5, 1 being the worst and 5 being the best, please rate the following questions:

    1. Please rate how courteous and helpful the staff was today.

    worst

    12345

    best

    2. Please rate how knowledgeable Dr. Feldman was regarding your issue today.

    worst

    12345

    best

    3. Please rate your overall satisfaction with how your issue was handled today.

    worst

    12345

    best

    4. Please rate your overall satisfaction with Feldman Wellness Center.

    worst

    12345

    best

    Your Name (required)

    Your Email (required)