Customer Feedback Form Sunshine Medical Centre& Family Practice Customer Feedback FormCompliments?Complaints?Suggestions?We value your feedback Doctor Visited * Date * MM DD YYYY Time * Hour Minute Second AM PM * Compliment Complaint Suggestion Other (detail below) Message * Optional: help us improve by rating the following: (Please mark the box next to your chosen response) The level of ease in booking your appointment is excellent. Strongly Disagree Disagree Neutral Agree Strongly Agree The waiting time for your treatment or appointment is great. Strongly Disagree Disagree Neutral Agree Strongly Agree The way you were included in making decisions about your treatment was what you wanted. Strongly Disagree Disagree Neutral Agree Strongly Agree The care or treatment you received from staff was of high standards. Strongly Disagree Disagree Neutral Agree Strongly Agree The way staff communicated with you was appropriate and respectful. Strongly Disagree Disagree Neutral Agree Strongly Agree The level of respect you received from staff needs to be improved. Strongly Disagree Disagree Neutral Agree Strongly Agree Would you like someone to call you in response to your feedback? * YES NO If 'YES' please fill in your name and contact number below: Thank you very much for your response! We take all feedback very seriously and use it to continue improving in all areas of practice. We continually strive to provide you with the best care possible. Get started and book an appointment with Sunshine Medical Centre & Family Practice today. Book an Appointment