Clinical Age Management Center, LLC

Satisfaction Survey

Please take a moment to answer these questions, so that we may continue to improve.

On a scale of 1-5, please mark your level of satisfaction.  1 means you are not all all satisfied, and 5 means that you are completely satisfied.

The Clinical Age Management Staff is:

Knowledgeable    1 2 3 4 5

Courteous    1 2 3 4 5

Prompt  1 2 3 4 5

How do you rate the following services of the Clinical Age Management Center?

Information Delivery   1 2 3 4 5

Medical Care    1 2 3 4 5

Telephone Response    1 2 3 4 5

Nutritional Consultation    1 2 3 4 5 Have Not Yet Scheduled

Fitness Consultation    1 2 3 4 5 Have Not Yet Scheduled

If you have not scheduled your fitness or nutrition consultation, please tell us why:

Do you have any suggestions on how we can better serve you?

Are you an active Age Management Patient?   Yes No

Thank you for your input.  We appreciate your time.