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Online Survey
Zen Clinic - Online Survey
Welcome to the Zen Clinic Survey from the Clinical Director
We are constantly trying to improve our levels of service and range of products at the
Zen Clinic
and your opinions and recommendations are paramount to our progress and providing the treatments that you want. Please help us by completing the short form below and submiting it to our marketing department.
By completing this short survey you will be entered into the quarterly
Prize Draw
to win an
Apple iPOD Touch
with music, movies and much more.
We look forward to meeting you again soon at the
Zen Clinic
. Thank you.
Yours sincerely
Dr. Ravi Suryavansi BDS. Ncle
How It Works
Please be assured
: All information we receive is held in the strictest confidence,
Zen Clinic
does not share data with any outside parties and it is used 'only' to improve our training, services and products.
Where applicable, simply tick in a box opposite the question your degree of satisfaction during your visit to the
Zen Clinic
.
A = Excellent, B = Very Good, C = Satisfactory, D = Not Good, E = Bad
Your Visit to the Zen Clinic
How did you rate the overall appearance of the
Zen Clinic
?
A
B
C
D
E
How did you rate the appearance of the Reception staff ?
A
B
C
D
E
Were they able to attend to you promptly and courteously ?
A
B
C
D
E
Did you find the inhouse posters and leaflets that you received informative and useful ?
A
B
C
D
E
Where did you hear about the
Zen Clinic
?
^
Your Treatment at the Zen Clinic
What department did you attend at the
Zen Clinic
?
How did you find the level of treatment that you received ?
A
B
C
D
E
Was the Therapist helpful and courteous ?
A
B
C
D
E
How did you rate the level of Treatment that you received ?
A
B
C
D
E
How did you rate the level of Advice you received from the Therapist ?
A
B
C
D
E
^
Other Treatments at the Zen Clinic
Do you currently attend other departments at the
Zen Clinic
other than the one you recently attended ?
Yes
No
Which department /departments ?
Are there any other treatments which might be of interest to you which we currently do not offer ?
^
About Your Lifestyle
What is your Postcode ?
Are you Male or Female ?
Your Age on your last birthday ?
What Daily / Sunday papers might your read ?
What Magazines might your read or subscribe to ?
What are your Hobbies ?
What are your favourite Holiday destinations ?
What is your favourite type of
Music ?
What is your Profession ?
What is your Job Title ?
Your Email ?
Please retype your Email ?
Thank You for taking the time to complete this survey. It will help us provide an even better level of service to you in the future.
^
