Doctor Testimonials
Finding a new doctor can be a stressful experience, especially in a big city. WISeR is collecting testimonials to help Rockefeller employees and students find good doctors to go to as well as doctors to avoid.

If you want to include more than one doctor, feel free to fill out this form multiple times!

NOTE: We may post your responses on our website, but this survey is ANONYMOUS. None of your personal information will be associated unless you include it in your response below.
Sign in to Google to save your progress. Learn more
What is your doctor's name? *
Feel free to include any other information that may be pertinent, such as the name of the clinic/practice, the address, the website link, etc.
What is their specialty? *
How would you rate your doctor? *
Please explain your response to the previous question.
Some questions to think about:  Was the doctor receptive of your health concerns? Did they make you feel comfortable in your identity? Were the staff and nurses helpful? Was it convenient to make an appointment/get a prescription?
Which insurance plan do they take? *
How far in advance do you have to make an appointment?
Clear selection
How long is the appointment wait time usually?
Clear selection
If you're comfortable, do you mind sharing whether your identity was important to why you recommend or don't recommend this provider?
Is there anything else you want to share?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms