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Patients Testimonials   After what is considered ”major surgery”, I took only five days off and was able to resume my normal work schedule the following week. more
Contact Us

T: (310) 375-8446

Gynecological
Oncology
Associates

23600 Telo Ave
Ste 250
Torrance, CA
90505-4037

Online Patient Questionnaire


First name: *
Last name: *
Street address:
City:
State:
Zip code:
Telephone: *
E-mail: *
Type of Treatment:
 Surgery (Please Specify): 

 Non-Surgery Related Treatment (Please Specify): 

 Doctor's Visit Because of a Problem: 

 Regular Check-Up: 

Overall Experience:
 Outstanding
 Satisfactory
 Dissatisfactory
Comments:
Experience with Doctor(s):
 Outstanding
 Satisfactory
 Dissatisfactory
Comments:
Experience with Nurse(s):
 Outstanding
 Satisfactory
 Dissatisfactory
Comments:
Experience with
Administrative Staff:
 Outstanding
 Satisfactory
 Dissatisfactory
Comments:
In which areas do you think we could improve?
What was the best part
of your experience?
Is there anything we could do that would have made your visit/procedure more comfortable?
Email
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Thank you for your participation in this survey.

Kindest regards,
Ramin Mirhashemi, M.D. FACOG and the staff at Gynecological Oncology Associates, GYNLA.com


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