Patient Care Survey

Collier-Laurence is committed to a positive patient care experience.

Your feedback will help us improve our services and your time is greatly appreciated.

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Step 2
How Helpful Was Our Staff
Scale: 5 = Outstanding, 1 = Needs Work
Step 3
Please rate the attentiveness and proactiveness of your provider.
Scale: 5 = Outstanding, 1 = Needs Work
Step 4
Please rate your satisfaction with the product you received.
Scale: 5 = Outstanding, 1 = Needs Work
Almost Done!
Would you agree to allow us to share your story?
Personal stories are displayed as testimonials on our website here: Answers you provide could greatly help others. We are kindly asking your permission to use your feedback in our marketing. By clicking below you are consenting to share information submitted in this form. Your exact wording will be used along with your name. If you choose not to share, your data will only be used internally to improve our services.

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