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Pediatrics-R-US
nurse@pediatricsrus.com
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Home
Appointments
Health Check
Immunizations
Nutrition
About US
Contact US
FeedBack
Financial Policy
Links
Blog
COVID-19
Services
FeedBack
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Your Feedback and Suggestions
Your opinion is important to us
please rate your visit and submit suggestions anonymously
Date of the visit:
Were appointment times available within a reasonable time?
select
Yes
No
Comments?
Were you able to get an appointment within the time frame that you wanted it?
select
Yes
No
Comments?
How likely are you to schedule a TeleVisit (online virtual visit) instead coming into the office to see the doctor?
select
Likely
Unlikely
What time of day would you prefer to have a telehealth visit? (mornings, early afternoons, late afternoon)
mornings
early afternoons
late afternoon
Was the front desk staff friendly and courteous to you?
select
Yes
No
Comments?
Were the office nurses friendly and courteous to you?
select
Yes
No
Comments?
Did the doctor spend enough time with you to address your needs and answer all your questions?
select
Yes
No
Comments?
Did the doctor listen and address any questions or doubts you have regarding your child’s care and provide the appropriate answers?
select
Yes
No
Comments?
Has your child had any labs or x-rays ordered by our doctor?
select
Yes
No
If the answer to above question is yes, were you notified of the results in a timely manner?
select
Yes
No
Comments?
Has our office completed any specialist referrals for your child?
select
Yes
No
If the answer to above question is yes, do you feel that our office handled this in a timely manner?
select
Yes
No
Comments?
Upon leaving, did you understood the diagnosis and medical treatments recommended by the doctor?
select
Yes
No
Comments?
Have we provided you with educational materials to help you understand the reason for your child’s visits?
select
Yes
No
If the answer to above question is yes, was the information helpful and/or did it answer all of your questions?
select
Yes
No
Comments?
Do you feel that our care team addressed all of your child’s health care needs?
select
Yes
No
Comments?
Any additional Comments?
Any additional comments?
Submit
Date of the visit:
Were appointment times available within a reasonable time?
select
Yes
No
Comments?
Were you able to get an appointment within the time frame that you wanted it?
select
Yes
No
Comments?
How likely are you to schedule a TeleVisit (online virtual visit) instead coming into the office to see the doctor?
select
Likely
Unlikely
What time of day would you prefer to have a telehealth visit? (mornings, early afternoons, late afternoon)
mornings
early afternoons
late afternoon
Was the front desk staff friendly and courteous to you?
select
Yes
No
Comments?
Were the office nurses friendly and courteous to you?
select
Yes
No
Comments?
Did the doctor spend enough time with you to address your needs and answer all your questions?
select
Yes
No
Comments?
Did the doctor listen and address any questions or doubts you have regarding your child’s care and provide the appropriate answers?
select
Yes
No
Comments?
Has your child had any labs or x-rays ordered by our doctor?
select
Yes
No
If the answer to above question is yes, were you notified of the results in a timely manner?
select
Yes
No
Comments?
Has our office completed any specialist referrals for your child?
select
Yes
No
If the answer to above question is yes, do you feel that our office handled this in a timely manner?
select
Yes
No
Comments?
Upon leaving, did you understood the diagnosis and medical treatments recommended by the doctor?
select
Yes
No
Comments?
Have we provided you with educational materials to help you understand the reason for your child’s visits?
select
Yes
No
If the answer to above question is yes, was the information helpful and/or did it answer all of your questions?
select
Yes
No
Comments?
Do you feel that our care team addressed all of your child’s health care needs?
select
Yes
No
Comments?
Any additional Comments?
Any additional comments?
Submit
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