Date of Visit:
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How were you greeted by the receptionist?
Courteously:
 
Timely:
 
How were you greeted by the employee who served you?
Courteously:
 
Timely:
 
Name of employee who served you (optional):
When you were served was the service courteous?
 
When served did our employee use your time together efficiently?
 
Was our employee knowledgable enough to answer your questions?
 
How was your wait time before being served?
 
How would you rate your experience with the Check-In kiosk?
 
How would you rate your overall experience?
 
Which division(s) served you?
Comments or suggestions on how we can better serve you: (optional)
Waiting Number (optional):
Name (optional):