Breast augmentation review by T.S.

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Thank you for taking the time to complete the following questionaire. Please circle, check, or fill in your responses. Return it in the enclosed self-addressed, stamped envelope.

What procedure(s) did you have performed during your most recent surgery?Breast Augmentation
How would you rate your final result(s)

Excellent ........................... Poor

Would you recommend our practise to your friends?

What was the best part about your consult?

Dr. Rodriguez has the best bedside manners 

Why did you select Dr. Rodriguez and our office for your surgery?

Prior surgeries 

What else could we have done to help you prepare for your surgery?

Nothing/Perfect. The girls in the office are amazing. 

How was your experience with the anestheologist?

Perfect 

Please indicate your experience in the recovery room:
Duration of recovery room time

Temperature in the recovery room

My pain management in the recovery room

Other, please explain:

 

Would you return to this office if you decide to have additional surgery

 

Which of the following factors influenced you to choose Dr. Rodriguez?

 

 

Were your telephone calls to our office handled to your satisfaction?

Additional comment about telephone handling

The girls are always so pleasant. Vanessa needs a bonus! Ha ha! 

Were you satisfied with the way your surgery was scheduled?

Additional comment about surgery scheduling

 

How well do you agree with the following statements? (If any item does not apply, leave blank)
The amount of time that I had to wait to get a consultation with Dr. Rodriguez was reasonable
I was satisfied with the information and surgical description provided by Dr. Rodriguez
The office staff was attentive to my needs
The OR staff was attentive to my needs
The written materials that I received prior to surgery satisfied my needs.
I was satisfied with the way I was prepared for surgery
I was satisfied with the care that I received the morning of surgery
I was satisfied with my follow-up care
The fees for surgery were reasonable
Additional Comments

Thank you for taking the time to complete this questionare
May we share your confidential comments with prospective patients

Would you like someone to call you regarding any of your responses

Name

T.S.