Patient Satisfaction Survey

Dear Parent/Family:

Our goal is to provide comfort, convenience, and satisfaction as well as the very best medical care to all of our patients. We would like to know how you feel about our medical services, our patient-handling systems, our physicians, and staff members. Your comments will hep us evaluate our operations to ensure that we are truly responsive to your needs.

Thank You for taking the time to fill out this questionnaire, your help is appreciated.

Please select the provider you most recently received care from. *
Type of visit: *
Was this your first visit at Sartell Pediatrics? *
Do you know that we have a website and updated Patient Portal? *
YOUR APPOINTMENT
Ease of making appointments by phone or patient portal *
Poor
Excellent
Appointment availability within a reasonable amount of time *
Poor
Excellent
The efficiency of the check-in process *
Poor
Excellent
Waiting time in the reception area or exam room *
Poor
Excellent
OUR STAFF
The friendliness and courtesy of the person who took your call or checked you in *
Poor
Excellent
The care and concern of our nurses *
Poor
Excellent
Ease of getting a referral when you needed one
Poor
Excellent
OUR COMMUNICATION WITH YOU
Your phone call was answered promptly and return calls are made in a timely fashion
Poor
Excellent
Your ability to obtain prescription refills
Poor
Excellent
Text, email, and phone call reminder services
Poor
Excellent
YOUR VISIT WITH THE PROVIDER
Willingness to listen to you and taking time to answer your questions *
Poor
Excellent
Amount of time spent with you and your child *
Poor
Excellent
The thoroughness of the examination *
Poor
Excellent
BILLING
Helpfulness of our business office
Poor
Excellent
Clarity of the billing statement
Poor
Excellent
Promptness in resolving billing / insurance questions or problems
Poor
Excellent
OUR FACILITY
Hours of operation that are convenient for you *
Poor
Excellent
Overall comfort *
Poor
Excellent
YOUR OVERALL SATISFACTION WITH:
Our practice *
Poor
Excellent
If you are not satisfied with any of the above topics, please tell us why
Your answer
If there is any way we can improve our services to you, please tell us about it
Your answer
Additional Comments
Your answer
About You
I am: *
Your Name (Optional)
Your answer
Phone Number (Optional)
Your answer
Would you recommend Sartell Pediatrics to a friend or family member? *
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