Home
CV
Anaesthetics
Event Medical Consultancy
Patient Info
Gallery
Feedback
Contact
More
Feedback
If you have had treatment with Dr Shamsuddin we would love to hear from you
Customer Feedback
name:
*
email:
Who are you filling this feedback for:
*
Please choose one of the following…
Yourself
Your Child
Your Partner
Another Relative or Friend
Which best describes the reason you saw Dr Shamsuddin:
*
Please choose one of the following…
A pre-operative assessment clinic
I’m having/had an operation
I have had an epidural
Treatment for chronic pain
A relative is having treatment
Other (please give details)
Other:
On a scale of 1 to 5, (1=Very Good 5=Very Poor) How was your experience with Dr Shamsuddin:
*
Please choose one of the following…
1
2
3
4
5
would you be completely happy to see Dr Shamsuddin again:
Yes
No
Please add any other comments you would want to make about Dr Shamsuddin:
send
This site is protected by reCAPTCHA and the Google
Privacy Policy
and
Terms of Service
apply.