Client Questionnaire

Thank You for visiting The Medical Spa at Nova!

Our goal is to provide you with the best physician directed preventative and restorative therapies available. Our services and products are designed to improve health and bestow long-lasting aesthetic benefits. Please take a few moments to complete this questionnaire to allow us to better serve you.


Getting Acquainted

Date of Visit:    

a. Is this your first visit to our spa?      Yes    No

b. Did our facility meet your expectations?      Yes    No

c. Is the spa clean and comfortable?      Yes    No

d. How did you hear about our spa?
    Advertisment    Doctor    Internet    Friend    Other

What concern or purpose were you addressing? What was the result?


Staff Performance

a. Was the staff courteous and professional?      Yes    No

b. Was the staff efficient?      Yes    No

c. Was the staff attentive to your needs?      Yes    No

d. Was the appointment-making process efficient and helpful?      Yes    No

e. Is the greeting and check-in process pleasant and efficient?      Yes    No

f. Which spa staff member did you see today?    

g. Would you recommend this provider to a friend?      Yes    No

Service

a. Which service did you receive?


b. Would you recommend this service to your friends?      Yes    No

c. How satisfied were you with the service?
    Very Satisfied    Satisfied    Average    Unsatisfied    Very Unsatisfied

d. What did you like most?


e. What improvements would you recommend?


Additional Comments (To receive 1,000 rewards points please include your name):