Let us know how we’re doing by filling out the brief survey below:

    How did you hear about CIDKC?
    ReferralSocial MediaOnlineRadioOther

    If Other, Please Explain:

    How likely are you to refer someone to CIDKC?
    1 (Not Likely)2345 (Very Likely)

    How likely are you to reserve an appointment at CIDKC again?
    1 (Not Likely)2345 (Very Likely)

    Did your appointment start on time?
    YesNo

    Did the team answer your questions?
    YesNo

    Did the team explain each part of your appointment and let you know what to expect?
    YesNo

    Tell us more about your visit!

    Do you have any suggestions or questions for us?

    Do we have permission to use your testimonial on our website and/or social media?
    YesNo

    This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.