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How was your experience?

Dear Sir / Madam,

Thank you for visiting us. We want to provide the BEST services for our patients. By filling out this quick survey you will help us obtain the very best results in order to continue to do just that. Let us know about your experience at Berkshire Facial Surgery!

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Your Procedure (Select all that apply):

Name of Doctor who provided care for you?

What intrigued you to seek treatment at Berkshire Facial Surgery?

Overall satisfaction

Will you return for additional care if needed?

Would you recommend us to family or friends?

How would you rate us?

We welcome your ideas, suggestions and comments on how we are doing, what you admire about us, and what we can do to make our patients’ visits more enjoyable:

May Berkshire Facial Surgery, Inc. display pertinent information provided by you via this survey on the company's public website for testimonial purposes?

Your Name:

Your Email:

Thank you for taking the time to fill out this survey. We appreciate your assistance.

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