Patient Survey

Thank you for taking the time to fill out our Patient Survey form!  Each item/response is optional.  Responses may be used in our promotional materials.

  • Overall, how was your experience?
  • Would you feel comfortable recommending us to your family or friends?
  • On a scale of 1-5, with 5 being the best, how would you rate the knowledge & friendliness of our team members?
  • On a scale of 1-5, with 5 being the best, how would you rate the quality and efficiency of Scheduling & Reception.
  • On a scale of 1-5, with 5 being the best, how would you rate the quality of treatment and care provided by the doctor?
  • On a scale of 1-5, with 5 being the best, how would you rate your overall experience with Drs. Delgado & Kuzmik
  • What did you like BEST about your visit to our practice?
  • What is something you might tell a friend about your experience with Drs. Delgado & Kuzmik? Please be as specific as possible.
  • Please list any other comments or suggestions on how we are doing and what we can do to make our patients' visits more enjoyable.