Feedback

How Are We Doing?

Thank you for taking the time to fill out this brief referrer feedback form. The purpose of this form is to ensure a top quality experience to all of our referrers and future clients.

Your Name

Position/Job Title

Is this your first time referring to us?

Yes

How did you hear about us?

Search Engine

Google Ads

Facebook Ads

Facebook Post/Group

Other social media

Radio

Newspaper

Word of mouth

Viewing or receiving printed promotional materials e.g. business card, brochure

Other

How satisfied were you with your patient/client’s support from us?

1 = Disappointed, 5 = Extremely Satisfied

What is the likelihood that you would refer to us again?

1 = Very Unlikely, 5 = Extremely Likely

Would you recommend our service to other service providers?

Yes

Please share your experiences of working with us and/or any suggestions you might have about how we might improve our services:

Do you give permission for Hōkai Tahi to use written feedback from this form to further the marketing of their service i.e. as a testimonial?

Yes

Contact us

0800 006 277

info@hokaitahi.nz

Wairarapa After Hours Service

Book an appointment

Masterton Clinic

21 Worksop Road, Masterton

Mon - Fri: 8:30am to 4pm

By appointment only.

South Wairarapa Clinic

8 Lyon Street, Featherston

Wednesday 9.00am - 4.00pm

Drop in 2.00 - 4.00pm

Donate

If you would like to help support the work we do at Hōkai Tahi, please get in touch with us using the link below for information about how you can donate.

Hōkai Tahi Charitable Trust CC54935

Donate

Where to find us

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0800 006 277

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Feedback

How Are We Doing?