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Overall how would you rate your experience with our practice
 
1. Excellent
 
2. Very good
 
3. Good
 
4. Fair
 
5. Not good
 
 
 
Would you refer your friends and family to our practice
 
1. Definitely Yes
 
2. Maybe
 
3. Definitely no
 
 
 
Do you like the online service
 
1. Yes
 
2. No
 
3. Maybe
 
 
 
Do you like the information provided on our website
 
1. Yes
 
2. No
 
3. Maybe
 
 
 
How satisfied were you with the amount of time Dr. Lakhani spent with you
 
1. Very satisfied
 
2. Satisfied
 
3. Somewhat satisfied
 
4. Dissatisfied
 
5. Very dissatisfied
 
 
 
Which aspect of our practice do you appreciate the most
   
 
 
 
Which aspect of our practice would you like to see an improvement in
   
 
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