Barrington Family Medicine, your suggestions on how we may improve our service to you is considered vital information. We want to meet your medical needs in every way. Your comfort with our service is imperative.

Please provide us with detailed feedback on your last visit or communications with our staff. We value any suggestions you have for us. We will then make improvements in our service to you. Unfortunately, you will not receive a response to your typed entry below, but we would be happy to discuss any issues further at your next appointment with us. Thank you!

*Name:

*Date of Birth:

Suggestions / Feedback:

   
*optional