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Electronic Intake Survey

Survey - Electronic Intake

Thank you so very much for providing feedback to our electronic intake process.   While we hope this provided a better experience than paperwork, we wish to learn how you felt about this process and ways we can continue to improve the patient intake experience.  Your input and candor are valuable and greatly appreciated!  Thanks again!
 
1. Please rate your intake experience (electronic intake instead of paperwork) on a scale of 0-10, with 0 being unacceptable and 10 being excellent: *This question is required.
0 - Unacceptable12345678910 - Excellent
2. How does this intake experience compare to previous intake forms you’ve completed? *This question is required.
  • This question is required
0%