HTFM Patient Portal

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

1 - Poor

2 - Average

3 - Great

4 - Excellent

No

Yes

No

Yes

1 - Poor

2 - Average

3 - Great

4 - Excellent

No

Yes

You can select a staff member from the drop down if you'd like to leave a comment about your experience. Please be advised these forms are sent privately to the Office Manager and are not shared with any of the staff. If issues arise from your concerns they will be handled with care and your identity will remain private.

Please select the date you were in the office. If you do not recall choose today.

Available Forms

Patient Satisfaction Survey

Patient Satisfaction Survey