Patient Testimonial

Thank you for sharing your experience with us! Your feedback helps us improve our services and lets others know about the quality of care we provide.

Patient Name

Date of Visit

Test Provided

EEG

ERP

1. How would you rate your overall experience with our healthcare services?

2. How did our staff make you feel during your visit?

Cared for

Respected

Comfortable

Other

3. Was there a specific staff member who made a positive impact on your experience? If so, please share how.

4. Is there anything else you’d like to share about your experience, our service, or any ways we can improve?

5. Do you give us permission to share your testimonial publicly (e.g., website, social media, marketing materials)?

Yes, I give my permission.

No, please keep my feedback private.