DR. POTPARIC OFFICE SURVEY Se Habla Español, Portuguese, French, Italian, Serbian and Croatian HOME If you'd like a response please enter your name or email address. Name:  Optional (We'd appreciate it if you could put your name in.) Email:  Optional Please submit your comments, concerns or questions: How would you rate your overall visit? Excellent Very good Average Not so good    When your appointment was over were all of your questions answered? Yes Not really I wish I knew more Were the financial options explained to you? Yes No I already understand my financial options Would  you refer your friends and family to us? Yes No I'm not sure Please comment on anyone you met during your visit, things we could change, new services you would like to see, or other ways we can make you feel more comfortable. We would appreciate it if you could explain why you decided to have or not have your surgery with us.   Comments / Questions: HOME

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