Patient Satisfaction Survey

A patient-centered experience begins with interactive dialogue between you, our physicians, and staff. Please complete the form below to share your thoughts and suggestions for our practice. Advanced Urology Institute is committed to our mission of advancing patient centered care. Your feedback and suggestions are crucial to this process. We are continuously striving to improve the experience of our patients, and our delivery of consistent and quality service.

We are happy to provide you with appointment resources to better process your paperwork and prepare you for your visit to our facility.

To make an appointment you can contact us directly (855) 977-4888 or you can complete the online appointment request below. When we receive the online request you will be getting a call or response within 24 hours.

For emergency, please call 911.

* 1. Name


* 2. Email Address


* 3. Who is your doctor?


* 4. Please tell us about your experience while at Advanced Urology Institute.
How well have the staff, doctors, nurses and the overall practice
served and supported you?


5. Is there anyone you would like to acknowledge or bring to our attention?
Please include any comments you would like to share.


6. If you have seen our physicians before, has the quality of our care:



7. Any additional comments and/or suggestions to improve our service are greatly appreciated.

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Need an appointment with a urologist? Have questions about prostate cancer? Advanced Urology Institute is a group of highly qualified and board certified urologists in Florida. Please call (855) 977-4888 or contact one of our locations today.