Post Operative Survey

Thank you very much for choosing our practice for your plastic surgery procedure. We would truly appreciate it if you could take a moment to fill out this survey. We are CONSTANTLY looking to improve our practice to ensure that all of our patients are 100% satisfied with their experience. We welcome all of your suggestions, praises, and critique.

Please select one to ten (1=Not likely at all, 10=Very likely)

For each section, please select one to five (1=very poor, 2=needs some work, 3=average, 4=very good, 5=beyond my expectations)

Initial Contact

First Visit to the Office

Surgery Scheduling


Post Operative Care


Thank you for taking the time to complete this questionnaire. The information you have provided will help us ensure the safe practice of plastic surgery.

Content written and approved by Darshan Shah, MD Plastic Surgeon.