Northeast Ohio Foot & Ankle Clinic, Inc.Complete medical and surgical care of the foot and ankleNortheast Ohio Podiatrist
Howland, Ohio Podiatrist
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Hubbard, Ohio Podiatrist
Treatment of feet and ankles
Brookfield, Ohio Podiatrist
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Dear Valued Northeast Ohio Foot, Ankle & Wound Center Inc. Patient,

At Northeast Ohio Foot, Ankle & Wound Center Inc., I strive to provide the best Podiatric care for you and your family. To do this well, I need your help! I am very interested in your opinions about my foot and ankle medical services. If you currently are or have been a patient of mine, please take a moment to complete the patient satisfaction survey below.

By completing the following survey you will be entered in a quarterly drawing to win a gift certificate at one of our fine local restaurants.

Thank You In Advance,

Dr. James J. LaPolla Jr. Northeast Ohio Foot, Ankle & Wound Center Inc.

Do you consider the staff at NEO Foot, Ankle & Wound Center Inc. professional and courteous?
Yes    No
Would you like us to call or see you for a current foot or ankle problem?
Yes    No
When you phone us, are your calls processed quickly and efficiently through the phone system?
Yes    No
Do we respond and follow through on your Podiatric questions and needs?
Yes    No
Was the Podiatric care that I provided to you in the past successful?
Yes    No
Did the quality of my Podiatric care meet or exceed your requirements and expectations?
Yes    No
Were the Podiatric services provided to you in the past, billed to you at the agreed or quoted price?
Yes    No
Have we followed-up by phone, mail or in person to make sure that the Podiatric care or surgeries were to your satisfaction?
Yes    No
Are there any changes in our medical services that I can make to better satisfy you as our patient?
Yes    No
Are there any foot and ankle medical care or services that you require that I do not offer?
Yes    No
Do you plan on using our foot and ankle medical care services from us in the future?
Yes    No
If not, why?
What suggestions can you make to help me ensure your future foot and ankle medical needs are properly addressed?
Name:  Company:
Phone:  E-mail:

8588 E. Market Street
Warren, OH 44484

7264 Warren-Sharon Rd.
Brookfield, OH 44403


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