Wufoo
IRMS Patient Satisfaction Survey
We're committed to monitoring the quality of the services and products we provide, as part of an ongoing improvement process. We would appreciate your feedback on our performance. (All submissions are anonymous.)
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* Enter the survey code provided to you.
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The code would be found at the front desk at an IRMS office or in the letter you received.
* In what office(s) were you seen?
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Livingston Only
Hoboken Only
Clark Only
Livingston Primarily
Hoboken Primarily
Clark Primarily
* Which of the following best describes the nature of your most recent visit(s)?
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Initial consultating/diagnosis/testing
IUI (insemination) Cycle
IVF Cycle
FET (Frozen Embryo) Cycle
Other
If Other (please specify)
* I achieved a pregnancy as a result of my most recent treatment.
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Yes
No
Not Applicable
* Which physician did you first see?
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Dr. Cekleniak
Dr. Chen
Dr. Garrisi
Dr. Greenseid
Dr. Keegan
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