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Is this your first visit or a return visit to the ABC clinic? 

  • First visit

  • Return visit


What is the main reason for your visit to the ABC clinic?

  • Friend or acquaintance recommendation

  • Good location

  • Medical staffs shown on TV

  • Article(s) in newspaper or magazine

  • Advertisement in the bus or subway

  • Advertisement on TV

  • Review on the Internet

  • Internet search

  • Advertisement on the Internet

  • Advertisement in newspaper or magazine

  • Other

What is the main reason for your revisit to the ABC clinic? (Only applicable for returning customers)

  • Friendliness of the medical staff

  • Good facilities

  • Competence of the medical staff

  • Friendliness of the employees

  • Good location

  • Other

What is your biological gender?

  • Male

  • Female


What is your age group?