1040 Woodcock Road, Suite 200 Orlando, Florida 32803
Phone: 407.898.4550 Fax: 407.898.4842
Patient Satisfaction Survey
How would you rate Your wait time?
Poor - Waited too long.
Fair - Ok, but could be shorter.
Good - As expected.
Excellent - Great timing.
How would you rate the friendliness of our Staff?
Poor - Not at all friendly.
Fair - Somewhat friendly.
Good - As Expected.
Excellent - Very Friendly.
Was your problem addressed?
No, it was not.
Yes, it was.
Very much so.
Are you satisfied with your visit?
No, not at all.
Yes, I'm satisfied.
Do you have any suggestions or comments?
Describe in detail (1000 characters available).
Would you like more information on any of the following treatments we provide?
(Please select any or all services which interest you)
Physician Directed Weight Loss Programs
Skin Care Products
Vitamin & Weight Control Supplements
Would you recommend our office to your friends & family?
Email is a
Baldwin Park Family Practice, P.A.
1040 Woodcock Road, Suite 200, Orlando, Florida 32803
Phone: 407.898.4550 | Fax: 407.898.4842 | E-Mail:
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