Alpharetta
770-475-6222

Atlanta
404-257-9933

Lilburn
770-921-4740

Paulding
678-363-3343

Buckhead
404-350-5777

ALL METRODERM OFFICES ARE OPEN AND ARE SEEING PATIENTS. PLEASE CALL AN OFFICE NEAR YOU TO MAKE AN APPOINTMENT.

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Patient Satisfaction Survey

We value you as our patient and invite you to take a few minutes to fill out this survey.

Step 1 of 3

33%

Please select one*
- Male
- Female
How old are you?*
- 20-29
- 30-39
- 40-49
- 50-59
- 60-69
- 70-79
- 80-89
- 90+
Please select your age range
Zip Code:*
ZIP / Postal Code
Are you a:*
- A New Patient
- An Established Patient?

If you are an established patient, how many years have you been coming to our practice?*
- 0-5
- 5-10 years
- 10-15 years
- greater than 15 years
How did you hear about us?*
- Friend/Relative
- Doctor / Health Professional
- Internet
Name or Website*

Name of the person you heard about us from or website:
Who is your primary care provider?*
How easy was it to make an appointment?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
How helpful and courteous was the staff that made your appointment?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
How easy was the check-in process?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
How helpful and courteous was the staff at check-in and check-out?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
How helpful and courteous were the medical assistants that helped your doctor in your clinical case?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
Did anyone hurt you during any procedure done at MetroDerm?*
- 1
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- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
Did you feel that the facility and staff were clean and used appropriate hygiene measures during your visit?*
- 1
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- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Did you feel that the facility and staff were clean and used appropriate hygiene measures during your visit?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments

Which physician or Physician's Assistant (PA) did you see today?*
How would you rate your visit with the physician or PA today?*
- 1
- 2
- 3
- 4
- 5
1 being least helpful, 5 being most helpful
Comments
Do you use a computer?*
- Yes
- No
Do you read reviews about doctors on the internet?*
- Yes
- No
Do you use Social Media?*
- Facebook
- Twitter
- Instagram
- All of them
Do you use / watch YouTube?*
- Yes
- No
Are you interested in cosmetic procedures?*
- Yes
- No
What type / types?
Would you like to receive info about new medical and/or cosmetic procedures done here at MetroDerm?*
- Yes
- No
Would you be interested in attending an Open House about new procedures or techniques?*
- Yes
- No
Overall, how would you rate your experience during your visit? (1 = poor, 5 = excellent)*
- 1
- 2
- 3
- 4
- 5
Suggestions for improvement / comments:
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How Can We Assist You

Name*
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Phone*
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What is your concern?
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Atlanta / Sandy Springs

875 Johnson Ferry Rd., NE
Suite 180, Suite 300
Atlanta, GA 30342

Office: 404-257-9933
Fax: 404-257-9931

Paulding

148 Bill Carruth Parkway
Suite 280
Hiram, GA 30141

Office: 678-363-3343
Fax: 678-363-3380

Lilburn

4150 Five Forks Trickum Rd.
Suite 3
Lilburn, GA 30047

Office: 770-921-4740
Fax: 770-921-1993

Alpharetta

3155 North Point Parkway
Building E, Suite 100
Alpharetta, GA 30005

Office: 770-475-6222
Fax: 770-667-9522

Buckhead

3193 Howell Mill Rd NW
Suite 220
Atlanta, GA 30327

Office: 404-350-5777

This website and MetroDerm, P.C. will adhere to all legal privacy requirements, as well as make every effort possible to assure the privacy if information submitted to this website or contained in any of our patient files. If you are on our mailing list please be assured that we will not share our mailing list, including your e-mail address, under any circumstances with third parties. MetroDerm, P.C. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The material contained on this site is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider. Click here for Notice of Privacy Practices.