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Patient Survey

Cosmetic Patient Satisfaction Survey

Dear Patient,

It is our priority, at the Center For Cosmetic & Reconstructive Surgery, to provide every patient with the best possible experience at our office. Please help us by sharing your thoughts and insight in the following questionnaire. We will use this information to make necessary changes and improvements in the way we provide services to you and all our patients. Thank you for your help providing us with this very important feedback.

Sincerely,
Dr. John Kotis

How did you discover Dr. John Kotis and The Center For Cosmetic & Reconstructive Surgery (CCRS)?

How was your experience, first contacting us at CCRS?

Were you able to schedule an appointment at the time you wanted?

Were the staff members helpful?

How was your experience when you entered our office?

Was the waiting room clean and welcoming?

How was the wait time during your most recent visit (this includes time in the waiting room and exam room)?

Was the Exam Room clean and inviting?

Cosmetic Patient Satisfaction Survey

How was your experience with Dr. John A. Kotis, DO? Was he friendly, kind, informative?

Did the doctor answer all your questions about your condition or procedure?

During your visit, did you feel that the doctor gave you enough of his attention?

If you were scheduled for surgery, were you provided with all necessary instructions?

Were you informed of your financial responsibility for the procedure in an appropriate manner?

If you had surgery or a procedure, were you made comfortable during your experience?

If you had surgery, did Dr. Kotis or his staff call you in 24 hours to check on your condition?

If you phoned our office after hours, and reached our answering service, were you contacted in a reasonable time?

If you phoned with a question for the doctor or staff, how was your experience? Was your question answered?

Would you recommend friends and family to Dr. John Kotis at the CCRS?

Overall, how was your experience at the Center For Cosmetic and Reconstructive Surgery?

I give Dr. John Kotis permission to use comments from the above survey, anonymously, for use on his printed material, website or other social media.

Patient Name:

Patient Email:

Thank you for your feedback!