First Name
  Last Name
Mobile No     (10 digits only)
  What was your primary reason for visiting Lotus Ayur Care?
Please mention the date of your visit(s), if possible.
How satisfied were you with the following aspects at Lotus Ayur Care?
Did you find our working hours convenient for you?
Did the waiting area look clean and orderly?
Was the receptionist helpful, polite and pleasant?
Were the assistant(s) friendly, supportive and confident?
Did the physician explain your treatment, answer your questions, and listen to your concerns?
How would you rate the overall quality of service you received at Lotus Ayur Care?
Additional Comments or Suggestions:
  If this is a complaint, do you wish to be contacted for follow-up?