Are you satisfied with our scheduling and check in process?

Yes
No

What is the best way to communicate with your office regarding AIS updates and information?

E-Mail
Outreach
Fax
Newsletters

How often would you like to receive outreach visits?

Monthly
Bi-Monthly
Phone Follow-Up Only

Are you receiving enough information and updates from AIS?

Yes
No

Have you visited our web site www.aisnepa.com before this survey?

Yes
No

Are evening and/or weekend hours important?

Yes
No

Enter your questions or comments in the space provided below:

Tell us how to get in touch with you: (optional)