Testimonial Questionnaire

Full NameWhat is your full name?

EmailWhat is your email address?

How would you rate the signup process for the research?

How would you rate the research staff specific to the research you had enrolled in

How would you rate the infrastructure of the research facility?

How satisfied were you during your treatment/therapy at our research facility?

considering your complete experience with our medical facility, how likely would you be to recommend us to a friend or colleague?

TestimonialBriefly describe any improvements or satisfactory comments you would like to share with the research facility.

Confirm

Agree to allow my testimonial to be shared anonymously on any social media medium, newspaper, website, etc.