723 Broad St, Duncansville, PA 16635
(814) 515-9919
dcfaber@altoonavein.com
Home
About Us
Insurance
Vein Disease
Contact Us
Blog
For Patients
Patient Portal
Online Screening
Advanced Vein Care Post-Treatment Questionnaire
Online Appointment Requests
Make A Payment
Advanced Vein Care
>
Advanced Vein Care Post-Treatment Questionnaire
Advanced Vein Care Post-Treatment Questionnaire
Advanced Vein Care Post-Treatment Questionnaire
Please enable JavaScript in your browser to complete this form.
1. How did you find Advanced Vein Care?
*
Newspaper
TV
Billboards
Internet
Former Patients
Other
2. How would you rate the ease of getting an appointment with Advanced Vein Care?
*
Very Easy
Easy
Difficult
Very Difficult
3. How would you describe your overall experience with Advanced Vein Care?
*
Very Good
Good
Poor
Very Poor
4. How would you rate your trust in our practitioner’s decision making?
*
Very High
High
Low
Very Low
5. Were you given a clear explanation about your condition and/or procedure?
*
Yes
Somewhat
Not really
No, not at all
6. Would you agree that all your questions were answered?
*
Yes
Somewhat
Not really
No, not at all
7. How would you rate the willingness of staff to spend time with you?
*
Very Good
Good
Poor
Very Poor
8. How would you rate the courtesy of our staff?
*
Very Good
Good
Poor
Very Poor
9. How would you rate the appearance and atmosphere of the office?
*
Very Good
Good
Poor
Very Poor
10. How likely is it that you would recommend Advanced Vein Care to a friend or loved one?
*
Very Likely
Likely
Not very likely
Not likely at all
Tell Us How We Did Overall. If there is anything you feel we should change, please give us your input here:
Website
Submit
Skip to content
Open toolbar
Accessibility Tools
Accessibility Tools
Increase Text
Increase Text
Decrease Text
Decrease Text
Grayscale
Grayscale
High Contrast
High Contrast
Negative Contrast
Negative Contrast
Light Background
Light Background
Links Underline
Links Underline
Readable Font
Readable Font
Reset
Reset