SURVEY & TESTIMONIAL
Feedback Form
Your opinion is important to us. We grow and learn from you.
So help us improve our service for your beauty journey.
Name
Treatment
Occupation
Age
Attending Nurse
Date of Appointment
Considering your complete experience with our clinic, how likely would you be to recommend us to a friend or colleague?
Excellent
Good
Bad
Terrible!
Please state your level of satisfaction with the process of booking an appointment with your health professional
Excellent
Good
Bad
Terrible!
Please rate your cosmetic injector in conducting the actual procedure
Excellent
Good
Bad
Terrible!
Please rate your cosmetic injector in creating a comfortable and pleasant experience
Excellent
Good
Bad
Terrible!
How long did you have to wait after being completely numbed to see your cosmetic injector?
Since how many months/years have you been visiting our clinic?
In the past year, how frequently did you visit our clinic?
How satisfied were you with the follow during your treatment at the medical facility ? In terms of...
Professionalism of our staff
Excellent
Good
Bad
Terrible!
Hygiene in the clinic
Excellent
Good
Bad
Terrible!
Care provided by our cosmetic injectors
Excellent
Good
Bad
Terrible!
Time that our cosmetic injectors have spent with you.
Excellent
Good
Bad
Terrible!
Attentiveness towards concerns
Excellent
Good
Bad
Terrible!
Treatment plan formulated by the cosmetic injector
Excellent
Good
Bad
Terrible!
Co-ordination between staff
Excellent
Good
Bad
Terrible!
Scripting process and friendliness of the doctor
Excellent
Good
Bad
Terrible!
Do you feel that our work hours are well suited to treat you?
Excellent
Good
Bad
Terrible!
How easy was it to navigate your way to our clinic?
Excellent
Good
Bad
Terrible!
How would you rate us on the following parameters:
Our concern for honesty and transparency
Excellent
Good
Bad
Terrible!
Quality of service received
Excellent
Good
Bad
Terrible!
Information provided towards your procedure
Excellent
Good
Bad
Terrible!
Do you know all about the services we offer?
I was told about all of them without asking
I was told after I asked for them
I was not told about them
How easy was it to get a follow-up appointment?
Excellent
Good
Bad
Terrible!
Send
Get empowerment mails and gifts from us!
Sign-up for our newsletter to receive it.
*
indicates required
Email Address
*
First Name
Last Name