Patient Care Survey - Exodus Healthcare Network

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1. What provider did you see?*

Were you seen in Family Practice or Urgent Care?

Family Practice

Urgent Care

How satisfied were you with the care given by your Provider?

Very Satisfied

Satisfied

Somewhat Satisfied

Not Satisfied

What did you like about your visit?

What can we improve from your experience?

If you would like to be contacted regarding your comments, please complete the following:

Name

Phone

Comments

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