Professor Dhatariya Would Like To Know About Your Recent Experience of His Services Date of Visit Overall, how was your experience of our service? Overall, how was your experience of our service? Very Good Good Neither Good nor Poor Poor Very Poor Don't Know Please can you tell us why you gave your answer? Please tell us anything we could have done differently to improve your experience. Are You Are You Male Female What age are you? What age are you? 16 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85 and over Privacy Privacy Plese tick this box if you DO NOT wish your comments to made public 9 + 14 = Submit Form
