Ankle and Foot Centers of America
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Patient Survey

Patient Survey

We would love to hear about your experience with Ankle & Foot Centers of America. Please take a few minutes to complete our quick online patient survey for the purpose of assisting us in better serving you and future patients.

Thank You!

Ankle and Foot Centers Patient Survey

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Your Name*
Date of Visit
MM slash DD slash YYYY
Ease of scheduling your appointment?
How would you rate the length of your wait time?
How would you rate the cleanliness of our office?
How would you rate the receptionist staff?
How would you rate the medical staff?
How would you rate the courtesy of the physician?
How would you rate the competence of the physician?
How would you rate your overall experience?
This field is for validation purposes and should be left unchanged.