Ultrasona St. Louis

Client Survey

Ultrasona highly values your feedback, after answering the questions 1 (Poor) to 5 (Outstanding) or N/A, please feel free to leave any comments. If you would like to be contacted regarding your survey, please enter your phone number and/or email. Thanks!

We especially encourage you to leave comments concerning any negative aspects of the Ultrasona experience.

On a scale from 1 (Not at all likely) to 10 (very likely), how likely are you to recommend our services?
1 2 3 4 5 6 7 8 9 10

	Poor		Acceptable		Outstanding
How would you rate the quality of service you received when you first contacted Ultrasona?	1	2	3	4	5	N/A
When you first arrived at our office, how would you rate the responsiveness, friendliness and attentiveness of the front desk personnel?	1	2	3	4	5	N/A
Were you greeted in a friendly, professional manner?	1	2	3	4	5	N/A
How well was the paperwork explained to you?	1	2	3	4	5	N/A
Did the Ultrasound Technician make you and your guests feel welcome and comfortable?	1	2	3	4	5	N/A
If you received a massage, please rate the quality of the massage.	1	2	3	4	5	N/A
Overall, was your experience at Ultrasona a positive experience, worth the time and expense?	1	2	3	4	5	N/A

Please add any additional comments concerning the service you received from Ultrasona:

If you would like to be contacted concerning your survey, please leave your contact information below:

Name:
Phone Number:
Email:

Thanks for helping us improve the service we provide!

Created by Dagny Design Group