We are committed to providing excellent service to our clients so we would really appreciate if you could take the time to fill out the following feedback form to let us know how we did. 
Name
Treatment Received
Date
Was the procedure and it's expected outcome explained fully?
How did you find the cost of the treatment?
Was the treatment aftercare provided and explained fully?
Were the potential risks and side effects explained fully?
Were there any treatment complications?
Efficiency with Enquiries 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Treatment Information 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Consultation 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Staff Professionalism 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Treatment Comfort 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Treatment Outcome 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Overall Facilities 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
Complaints Handling 1 = Poor 2 = Adequate 3 = Average 4 = Very Good 5 = Excellent
If there were any treatment complications, what were they?
How were they resolved?
Please describe your experience with Aspire Aesthetics
Would you be happy for your comments to be shared as a testimonial for Aspire Aesthetics Ltd?
If yes, would you like this to be anonymous?
Any additional comments?