Patient Satisfaction Survey Dr. Benderev

At Vasectomy Docs, Dr. Ted Benderev and his staff strive to provide exceptional patient care. Your feedback is an essential element in helping us achieve this goal. To ensure we are doing our best please identify areas where we have met your expectations and where we can benefit from additional improvements. Thank you for selecting Vasectomy Docs and completing this confidential survey.

If you have a concern, please speak with our Practice Manager. If you have a compliment, please share your comment!

Patient Name

Please rate your satisfaction with the following aspects of your VASECTOMY EXPERIENCE.


SCHEDULING OF APPOINTMENT
1. Ability to schedule appointment
PoorFairGoodExcellentNot Applicable

2. Staff was friendly and helpful
PoorFairGoodExcellentNot Applicable

VASECTOMY CONSULTATION/COUNSELING BY DOCTOR
1. Wait time
PoorFairGoodExcellentNot Applicable

2. Doctor answered all my questions and responded to my concerns
PoorFairGoodExcellentNot Applicable

VASECTOMY PROCEDURE/AFTERCARE INSTRUCTIONS
1. Wait time for doctor
PoorFairGoodExcellentNot Applicable

2. Comfort level (adequacy of pain control)
PoorFairGoodExcellentNot Applicable

3. Explanation of aftercare
PoorFairGoodExcellentNot Applicable

OVERALL RATING

Would you recommend Vasectomy Docs?
YesNo

If YES, Please tell us why. If NO, please tell us how we can improve:

May we share your comments with others on our website?
YesNo
If so, please give us your first name and last name initial (example: Dan P)

Meet The Docs

Ted Benderev, M.D., & Robert Pugach, M.D., Founders of Vasectomy Docs.
(Run time 3:37)

Gold Standard Vasectomy

No-Needle No-Scalpel, 15 minutes...
No Kidding!
(Run time 5:25)

Why Go Anywhere Else?®

Quality standards, 100% money back guarantee, cash pricing....
(Run time 37 secs)

Vasectomy Doc Offices

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