Satisfaction Form

Thank you for your patronage.

Mor-Mar Ltd. works to improve the quality of service and to provide the most comfortable
setting possible, with a pleasant atmosphere and where our professional staff provide
personalized attention using modern, advanced equipment.

In order to continue to improve our level of service,
your opinion is important to me.
I welcome your comments and thoughts about the service that you received from our company.

I would appreciate your taking a few minutes to fill in the questionnaire.

Thank you,
and wishing you good health
Michael Ringart, CEO

WHAT IS YOUR LEVEL OF SATISFACTION REGARDING THE FOLLOWING?
Please place an in the appropriate box

	Very Unsatisfied	Unsatisfied	Somewhat Satisfied	Satisfied	Very Satisfied
WHEN YOU MADE YOUR APPOINTMENT
The amount of time you waited for a service representative when you called our customer service center
The explanations and instructions from our customer service representative regarding how to prepare for your procedure
The length of the waiting period from the time that you made the appointment by telephone until the date of the actual procedure
UPON YOUR ARRIVAL AT THE INSTITUTE
The surroundings and the attention provided while you waited for your procedure
The length of your wait from the time that you arrived at the examination site until the procedure was performed
The personal attention and level of service from the office staff in the reception area
FROM THE BEGINNING OF THE PROCEDURE
The explanations and instructions given by the staff about the course of the procedure
The attention and care provided by the medical staff before, during and at the end of the procedure
The surroundings and comfort during the procedure