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Thank you for completing the form below. Your feedback is important and may be used for promotional reasons.  The information you provide will never be used  or shared with your name attached or in any way which identifies you or your child.


OverallNeverUnlikelyMaybeProbablyHighly recommendOverall
ExplanationPoorlyNot very wellAdequateWellVery wellExplanation

Explanation - How well did your specialist explain the 

condition and provide you with relevant information?

Bedside MannnerPoorUnsatisfactorySatisfactoryGoodExcellent Bedside Mannner

Bedside Manner - How would you rate the

professional's bedside manner?

Thanks for submitting!

Overall - Would you recommend the care you

received from the specialist?

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