Your suggestions and comments are important to us and help us to improve our services. Physician / Provider Name: Patient Name (optional): Patient Email (optional): Was this your first visit? Yes No Did you have a scheduled appointment? Yes No Will you return for additional care? Yes No Would you recommend us to a friend? Yes No How would you rate our staff? Office Receptionist / Telephone Personnel: Physician / Provider: Waiting Time: Overall Staff Rating: How were you referred to us? Comments:
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Adult Medicine, PC 1 Pinnacle Place, Ste. 203, Albany, NY 12203 Phone: 518-438-4700 Fax: 518-438-3190