Exit this survey

PAMPA Patient Survey 2018

1. PAMPA Patient Satisfaction Survey

The purpose of the survey is to allow our practice to improve the experience of parents and patients. Thank you in advance for providing your invaluable feedback.

Question Title

* 1. Which office did you visit?

Question Title

* 2. What day did you visit our practice?

Question Title

* 3. What time of day was your appointment?

Question Title

* 4. Which provider did you see?

Question Title

* 5. Please rate your experience with the following:

	Excellent	Good	Fair	Below Expectation	Need of Improvement
How would you rate the scheduling secretary who assisted you with today's appointment?	How would you rate the scheduling secretary who assisted you with today's appointment? Excellent	How would you rate the scheduling secretary who assisted you with today's appointment? Good	How would you rate the scheduling secretary who assisted you with today's appointment? Fair	How would you rate the scheduling secretary who assisted you with today's appointment? Below Expectation	How would you rate the scheduling secretary who assisted you with today's appointment? Need of Improvement
How would you rate the secretary who greeted you at sign in?	How would you rate the secretary who greeted you at sign in? Excellent	How would you rate the secretary who greeted you at sign in? Good	How would you rate the secretary who greeted you at sign in? Fair	How would you rate the secretary who greeted you at sign in? Below Expectation	How would you rate the secretary who greeted you at sign in? Need of Improvement
How would you rate the nurse who escorted you to your exam room?	How would you rate the nurse who escorted you to your exam room? Excellent	How would you rate the nurse who escorted you to your exam room? Good	How would you rate the nurse who escorted you to your exam room? Fair	How would you rate the nurse who escorted you to your exam room? Below Expectation	How would you rate the nurse who escorted you to your exam room? Need of Improvement
How would you rate the patient account rep who helped you at check out?	How would you rate the patient account rep who helped you at check out? Excellent	How would you rate the patient account rep who helped you at check out? Good	How would you rate the patient account rep who helped you at check out? Fair	How would you rate the patient account rep who helped you at check out? Below Expectation	How would you rate the patient account rep who helped you at check out? Need of Improvement
How would you rate the provider who cared for your child today?	How would you rate the provider who cared for your child today? Excellent	How would you rate the provider who cared for your child today? Good	How would you rate the provider who cared for your child today? Fair	How would you rate the provider who cared for your child today? Below Expectation	How would you rate the provider who cared for your child today? Need of Improvement

Comments:

Question Title

* 6. Please provide any additional feedback that you feel would help our practice improve our service. If we did a great job, then please let us know that too!