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SURVEY
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Telehealth Visit Feedback Survey
Collect feedback on virtual appointments and video call quality.
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Preview — how respondents will see this form
How would you rate your telehealth visit overall?
*
How was the video and audio quality?
*
Excellent
Good
Fair
Poor
Were you able to join the call without technical issues?
*
Yes
No
I felt as well cared for as an in-person visit.
*
3
Strongly Disagree
Strongly Agree
How could we improve virtual visits?
Long answer…