How would you rate our services?
Excellent Good Average Below Average
How often do you visit us?
Weekly Monthly Occasionally First time
Which department do you visit?
Cardiology Pediatrics Orthopedics General
How do you book appointments?
Online Phone In-person Not booked yet
Would you recommend us?
Definitely Probably Not sure No
All set, how can we reach you?
Name
Email
Phone
(Details here)
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