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Telehealth Visit Feedback

Feedback specific to a virtual/telehealth appointment experience.

4 questions

Rating (1-5)

1. How would you rate the video/audio quality of your visit?

Required
Single choice

2. Was the telehealth platform easy to use?

  • Very easy
  • Somewhat easy
  • Somewhat difficult
  • Very difficult
Rating (1-5)

3. How satisfied were you with the care you received?

Long text

4. Any technical issues or suggestions?

Use this template