FEEDBACK FORM

Thank you for choosing us for your plastic surgery procedure. We are very grateful for the trouble you have taken to share your honest thoughts with us.

Please provide the following contact information:
Your personal data
*

* Required

RATING SCALE

1 = Excellent, 2= Very Good, 3= Good, 4= Mediocre, 5= Poor

Initial Enquiry & information provided
1  2 3 4 5

Consultation
1  2 3 4 5

Hospital
1  2 3 4 5

Accommodation
1  2 3 4 5

Rate your experience
1  2 3 4 5

Did the surgeon meet your expectations?
Yes  No

What did you find the most beneficial?