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Patient Satisfaction Survey
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HIPAA
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1
Overall, how satisfied are you with the services provided by Raleigh Wellness & Behavioral Health?
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2
Patient name
First Name
Last Name
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3
What could we do to improve?
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4
Would you like to provide your name?
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No, remain anonymous
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5
Patient Name
First Name
Last Name
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6
Google Reviews! We love them! We need them!
If you are willing to leave a Google review, you will be entered for a chance to win a $100 Amazon gift card (raffle is done 1 per month) -
if YES, click "YES" and "SUBMIT"- below and you will be redirected to Google.
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