Client Satisfaction Survey

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  • Advocate

    The following questions pertain to the Advocate Assigned to your case.
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  • Billing Department

    The following questions pertain to the Billing Department of Scioli & Associates, P.C.
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  • An exceptional value, worth more than you paid for.A good value, worth about what you paid for.A poor value, too expensive and worth less than what you paid for.Not Sure
  • General Office

    The following questions pertain to the general office and services of Scioli & Associates, P.C.
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  • Authorization and Release Information

  • I understand my testimonial as outlined above and made on behalf of Scioli & Associates, P.C. may be used in connection with publicizing and promoting Scioli & Associates, P.C. I authorize Scioli & Associates, P.C. to use my name, brief biographical information, and the Testimonial as defined on this form.

    I hereby irrevocably authorize Scioli & Associates, P.C. to copy, exhibit, publish or distribute the Testimonial for purposes of publicizing Scioli & Associates, P.C.'s programs or for any other lawful purpose. These statements may be used in printed publications, multimedia presentations, on websites or in any other distribution media. I agree that I will make no monetary or other claim against Scioli & Associates, P.C. for the use of the statement.

    In addition, I waive any right to inspect or approve the finished product, including written copy, wherein my likeness or my testimonial appears.

    I hereby hold harmless and release Scioli & Associates, P.C. from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

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