Newtown Center Pediatrics would like your feedback!
By sharing your thoughts and feelings, you can help improve the care we provide. Please complete the survey based on your child's recent visit.
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Email *
Wait time at our office *
Ease of scheduling your child's appointment *
Ease of contacting (e.g., email, phone, portal) the office *
How well the nurse listened to you regarding your child *
Concern the nurse showed for your child's problem *
Concern the care provider (DR, APRN or PA) showed for your questions or worries about your child *
Explanations the care provider gave you about your child's problem or condition
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Care provider's discussion of any proposed treatment (options, risks, benefits, etc.) *
Likelihood of your recommending this care provider to others *
How well the staff worked together to care for your child *
Patient's Name: (optional)
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