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Patient Survey
2020-10-14T16:08:00-06:00
We Want to Hear from You!
Please fill out this survey about your experience so we can learn how to better serve you.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Phone
*
Please enter your phone number, so we can follow up with you.
Clinic Visited
*
Carlsbad
Hobbs
Roswell Cancer Treatment Center
Roswell Multidisciplinary Clinic
Timeliness of Appointment
Selected Value:
5
0 = Not Timely // 5 = Very Timely
Level of Satisfaction
Selected Value:
5
0 = Not Satisfied // 5 = Very Satisfied
Quality of Treatment
Selected Value:
5
0 = Not Satisfied // 5 = Very Satisfied
Would you return?
*
Yes
No
Additional Comments
*
Comment
Submit
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Carlsbad
Hobbs
Roswell Cancer Treatment Center
Roswell Multi-Disciplinary Clinic
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