Consultation Survey

What was the purpose of your visit to our office?

Were you greeted friendly and courteously when you arrived at the office?

yes

no

The amount of time you had to wait before being seen by Dr. Grazer?

If you had a treatment today, what did you have done. You may pick more than one answer.

botox

fillers

facial

post operative appt

Do you feel that all your questions and concerns were addressed?

If you had botox, fillers or a facial, how do you feel about your treatment?

Would you return to our office again for the same procedure?

yes

no

maybe

not applicable

Would you refer your friends and family to our office?

yes

no

Please feel free to leave your comments. Your feedback is critical and we appreciate your time. Thank you!

Office Visit Survey