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Patient Satisfaction Survey
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Today's Date
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YYYY
Which Quickmed Youcare School Clinic did you visit?
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Cleveland Brush
Crestview
Liberty
TCTC
Youngstown Chaney
Youngstown East
Youngstown McGuffey
Youngstown P. Ross berry
How friendly was the staff at Quickmed's Youcare Clinic?
Not Friendly
1
2
3
4
5
6
Very Friendly
Clear selection
How likely are you to recommend Quickmed's Youcare Clinic to a friend?
Not Likely
1
2
3
4
5
6
Very Likely
Clear selection
How satisfied are you with your overall visit and care you received at Quickmed's Youcare clinic?
Dissatisfied
1
2
3
4
5
6
Satisfied
Clear selection
Was the reason for your visit addressed?
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Yes
No
What did we do well?
Your answer
What areas do you think we should improve on?
Your answer
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