New Patient Survey

How did you schedule your appointment?

Message:

Was it easy to schedule your child’s appointment? Why or why not?

How long did you have to wait for an available appointment?

Did you receive clear instructions about what to bring or expect for your visit?

How would you rate the check-in process?

New Field:

Did you experience any delays or confusion at check-in?

Were the required forms or paperwork clear and easy to complete?

New Field:

How long did you wait before being called back for your child’s visit?

Was your child comfortable during the vitals check (weight, height, temperature, etc.)?

Was the nurse or medical assistant friendly and attentive?

New Field:

Did your doctor explain things in a way that was easy to understand?

Did you feel that your child’s health and well-being were a priority during the visit?

On a scale of 1-10, how would you rate your overall experience?

What did you like most about your visit?

What could we do to improve your experience in the future?

Would you recommend our practice to other families?

Any additional comments or suggestions?