Lake Serene Clinic

Walk-In & Appointment
Make an appointment -- or walk-in any day of the year

Primary family care since 1990

3501 Shelby Road, Suite B
Lynnwood, WA 98087
425.742.9119

Patient Survey

Thank you for visiting the Lake Serene Clinic. We sincerely hope your experience has been a positive one. As we are constantly looking for ways to improve our facility, your opinions, suggestions, compliments and complaints are a big help.

Please take a few seconds to complete this survey. Any information you provide will be kept strictly confidential. Only include your name if youd like someone to contact you.


Age:	Sex: M F

Name (optional):	Phone (optional):

Email (optional):	Check to join our email list

How did you hear about our clinic?
Family doctor Friend/family member Advertisement Another patient The sign out front Internet search	Everett Yellow Pages S. Snohomish Yellow Pages N. King Yellow Pages Sno/King Yellow Pages Other (please specify):

How long did you have to wait to be seen?
0-5 minutes 5-15 minutes 15-30 minutes	30-45 minutes 45-60 minutes An hour or more

Please tell us what you think of our clinic:
	Poor	Below average	Average	Above average	High
Comfortable and attractive facility
Convenient location
Our "no appointment necessary" policy
Courteous staff
Comforting and knowledgeable practitioner
Practitioner took time to explain your situation
The amount of time the practitioner spent with you
Chance you would you return or refer us to a friend

Please feel free to add any additional comments:

Lake Serene Clinic

Walk-In & Appointment Make an appointment -- or walk-in any day of the year

Primary family care since 1990

Patient Survey

Walk-In & Appointment
Make an appointment -- or walk-in any day of the year