Which location did you visit?
How would you rate our concern for your child's privacy? Outstanding Good Adequate Needs Improvement Poor N/A
How often have you visited Growing Child Pediatrics within the past year? First Visit 2-5 Visit More than 6
Did you schedule an appointment by phone or did you drop in? Scheduled by Phone Dropped In
If you scheduled an appointment, did you have to wait longer than expected to get scheduled? Yes No
How easy was it to make an appointment by telephone? Very Easy Easy Somewhat Easy Average Somewhat Difficult Difficult Very Difficult
Was the person who scheduled your appointment courteous and helpful? Very Courteous Courteous Average Rude Very Rude
If you were seeking a referral to a specialist, was your request handled in a timely manner? Yes No
How would you rate the courtesy of the staff at the reception desk? Very Courteous Courteous Somewhat Courteous Average Somewhat Rude Rude Very Rude
How long did you wait in the reception area beyond your scheduled appointment time? 0 to 5 minutes 5 to 20 minutes 20 to 40 minutes Other
How long did you wait in the exam room before the physician appeared? 0 to 5 minutes 5 to 20 minutes 20 to 40 minutes Other
How would you rate the competence of the nurse who helped you? Outstanding Good Adequate Needs Improvment Poor N/A
How would you characterize the concern that the nurse showed for your problems? Outstanding Good Adequate Needs Improvment Poor N/A
Were you able to see the doctor of your choice? Yes No N/A
Did you feel that your doctor spent an adequate amount of time with you? Yes No N/A
Mark the boxes that characterized the demeanor of your doctor? Attentive Concerned Friendly Distracted Rushed Inconsiderate
How would you rate the competence of your doctor? Outstanding Good Adequate Needs Improvment Poor N/A
Did you feel your doctor's examination was thorough? Yes No N/A
Please rate the clarity of the doctor's explanation of your condition and treatment options: Outstanding Good Adequate Needs Improvement Poor N/A
How well did your doctor include you in healthcare decisions? Outstanding Good Adequate Needs Improvement Poor N/A
Were your questions answered to your satisfaction? Yes No N/A
Would you recommend this facility and its staff to your family and friends? Yes No N/A
Please list any areas in which our services could be impoved.
Providing the following information is optional.
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Would you like someone to contact you regarding your responses on this survey? Yes No