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| 1) Did we meet your expectations with regards to the following: |
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a. Patients please answer (a) then proceed to Number 2 |
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b. Physicians, Case Managers or Insurance Adjusters please answer (b) then proceed to Number 2. |
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| 3. What were your expectations of our service(s)? |
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| 5. What could we do better/different? |
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| 6. Additional Comments: |
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