Feedback test page

Web Site Feedback Questionnaire

Please take a few minutes to let us know your thoughts on this web site. We are constantly working to make improvements and give our patients as much information as they may need. We welcome and value any feedback and suggestions you may have, positive and/or negative.

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Name(required)

Email(required)

Website

Design and Layout 1 2 3 4 5 6 7 8 9 10

How could this be improved?

Ease of navigation 1 2 3 4 5 6 7 8 9 10

How could this be improved?

Usefulness of content 1 2 3 4 5 6 7 8 9 10

How could this be improved?

What do you like and dislike about the web site?(required)

Would you like to see any improvements / new features added to the web site?(required)