Patient Survey – Rainbow Pediatric Center

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Patient Satisfaction Survey

We Appreciate Your Feedback!

The only way that we can continue to improve our services here at Rainbow Pediatric Center is from hearing from our families. Thank you for taking the time to help us improve our practice!

1. What was the date of your appointment?

2. Which office did you visit?

3. Which provider did you see?

4. Was easy getting through our phone lines to set an appointment?

Yes No Waited longer on hold than 1 minute Waited on hold longer than 5 minutes No comment

5. Were you able to make an appointment for a convenient date and time?

Yes No No opinion

6. Were the registration/waiting areas welcoming, clean, and comfortable?

Yes No No opinion

7. The professional skills of the following staff were personable, competent, respectful:

Rate your satisfaction with the following items

8. Phone Appointment Scheduling

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

9. Registration

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

10. Medical Assistant Vitals

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

11. Provider

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

12. Check Out

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

13. Billing

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

14. Referrals

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

15. Explanation of exam, tests, and treatment

Extremely Satisfied Satisfied Unsatisfied Extremely Unsatisfied No Opinion

16. Let us know some things you were satisfied with:

Rate the length of time spent in our office

17.The length of time in the lobby

Adequate Shorter than expected Longer than expected

18.The time spent with nurse to perform vitals and questions

Adequate Shorter than expected Longer than expected

19.Time spent with provider

Adequate Shorter than expected Longer than expected

20.Total length of time spent in office

Adequate Shorter than expected Longer than expected > 1hr

21. Did you have to call the office after your visit for any reason?

22. Were prescriptions/medications sent?

No Yes Not Applicable

23. Were any referrals made?

No Yes Not Applicable

24. If you had labs performed, how long until you heard the results?

25. Do you have unanswered questions about your visit?

No Yes Not Applicable

If you have unanswered questions, please provide your e-mail or phone so we can get in touch with you.

26. Would you recommend Rainbow Pediatrics to friends and family?

No Yes

27. Do you use our HEALOW Kids app?

Yes No Love it! Not helpful No opinion

28. Do you like the check in kiosks?

Yes No Prefer to check in with a person Did not use No opinion

29. Do you follow us on Facebook?

Yes No

30. Do you have any feedback that can help us improve our services?

Contact us today for expert pediatric care!

904 . 223 . 9100

Fax Number: 904 . 223 . 9282

4788 Hodges Blvd.

Jacksonville, FL 32224

101 Marketside Ave.

Ponte Vedra, FL 32081

Copyright © 2019. Rainbow Pediatric Center. All Rights Reserved.

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