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Company:
Name:
Position:



Please respond to the following questions about your experience with AOM:



Very Satisfied Satisfied Not Satisfied
The manners of the person who scheduled your appt.
Prompt return on calls (after leaving messages)
Scheduling in a timely manner (drug testing, Workers' Comp, physicals)
Completed office visit in a timely manner
Communications about employee condition and treatment plan
Response to your follow-up questions
Your interaction with AOM staff
Referrals to specialists and/or testing

Please give us your feedback:



Do you prefer for your employees to be seen at AOM or by PT/specialist during:

Business Hours
After Hours (i.e. employees' personal hours)

Comments:


- Positive:






- Negative: