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Tell Me How I Did!

As a resident physician, I get the privilege to work in a variety of settings and meet patients from all different walks of life. This is a place to hear directly from my patients about their experiences they've had working with me, and a way for me to continually improve my skills as a physician and healthcare leader. Thank you for your time - Dr. Paul Clancy.

What is Your Name?

First name or initials is fine. You can also leave this blank.

Do you have any comments about our experience?

How was your experience?

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Consent

This form is personal and independently created by Dr. Paul Clancy. It is not affiliated with the University of Michigan or Michigan Medicine, is not part of any official patient experience survey, is not part of your medical record, and is not seen by your care team.
Sharing feedback is completely voluntary and will not affect your care in any way. Please don't include any medical details, diagnoses, or test results. If you have a medical concern, contact the clinic, call 911 or go to the nearest emergency department.