12 Month Survey – Hair Transplant Clients

Survey 12 Months Post-Procedure

We’d love to hear about your experience with us!

4 Month Post-Procedure Survey

First Name

Last Name

Phone/Mobile

Consultant's Name:

Procedure Date:

How would you rate the below for your consultation experience?

How would you rate the below for your interaction with the front office staff?

How would you rate the below for your surgical experience?

Additional comments you'd like to share about your experience:

Thank you so much for your time. Please feel free to call 317-522-2995 with any questions or concerns that you may have. We are always here to help.

Our affiliates:

Contact

3500 DePauw Blvd. Suite 2011

Indianapolis, IN 46268

(317) 522-2995

DISCLAIMER: Treatments may not work for you. Photos and videos are for illustration purposes only. Results may vary and are dependent on the individual patient, the procedure or treatments performed, and compliance with aftercare instructions. The information provided on this website is for general knowledge purposes only and is not intended as medical advice. It should not be used to diagnose or treat a medical condition. Professional hair transplantation services are provided by physicians of PAI Medical Group.

	Poor	Below Average	Average	Above Average	Excellent
Knowledge and explanation of the procedure
Professionalism
Level of care
Post-surgical follow-up

	Poor	Below Average	Average	Above Average	Excellent
Overall professionalism
Understanding of required forms/documents
Communication skills

	Poor	Below Average	Average	Above Average	Excellent
Listened to and understood my needs
Fully explained the surgical procedure
Performed in a professional manner
Level of care

	Poor	Below Average	Average	Above Average	Excellent
Overall professionalism
Attitude (helpful/caring)