Satisfaction Survey

Foot and Ankle Satisfaction Survey


Thank you for taking the time to visit our Satisfaction Survey and Testimonials page.

Whether you’re being treated for a total ankle joint replacement, ankle and foot arthritis, flat feet, cavus feet, paralytic foot, bunions, hammer toe, a complex foot and ankle fracture or other foot and ankle conditions, we’d like to hear from you.

Dr Black Survey

“It’s important to me that you receive outstanding customer service, which is why I personally review each of these Satisfaction Surveys.

While it’s not feasible for us to respond to each survey, please know that I, and my staff, appreciate your time in completing the following short survey – your voice will be heard.”

~ Michael R. Black, DPM, AACFAS

We value each and every one of our patients and we’d love to hear more about your experience with us – good or bad.

Whether you came to see Dr. Black, received physical therapy, or just made contact with our Orthopedic Associates office, we are interested in how you were treated.


Start Satisfaction Survey

Date of Appointment:

Please Choose Office:

Doctor Seen:

Ease of appointment setting.
Excellent Good Fair Poor 

Overall friendliness and courtesy of Front Office Staff.
Excellent Good Fair Poor 

Overall friendliness and courtesy of Medical Assistants.
Excellent Good Fair Poor 

Overall friendliness and courtesy of X-ray Staff.
Excellent Good Fair Poor 

Overall friendliness and courtesy of Therapy Staff.
Excellent Good Fair Poor N/A 

Informative answers were provided to my billing and insurance questions.
Excellent Good Fair Poor N/A 

Overall Cleanliness and Comfort of the office:
Excellent Good Fair Poor N/A 

My doctor provided me with a comprehensive explanation of my diagnosis and treatment plan.
Excellent Good Fair Poor N/A 


We strive for "Excellent" in all categories. If you feel that you aren't able to comfortably give us an "excellent" score, please let us know why in the box below so we may improve!

Your thoughts on how we could improve:


If you'd like to include a positive testimonial of your experience, we'd greatly appreciate you taking the time to do so in the box below. Thank you!

My Positive Testimonial:


Please note that we'd like your permission to include your positive testimonial on our website and/or Facebook Page and by using this form, you are granting us permission to do so using your first name and last initial only.

Your Name (required)

Your Email (required)

How did you first learn about Dr. Michael Black?


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