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Was
our waiting room welcoming? |
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Who welcomed you when you walked in? |
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Was
your reception friendly? |
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How
long did you have to wait in our waiting room?
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How
long did you have to wait once back in our exam rooms? |
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Who was your medical assistant? |
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How
would you rate the professionalism of the medical assistant? |
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How
would you rate his/her professional appearance, i.e. dress, hygiene,
etc.? |
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Who
was the practitioner who cared for your child? |
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How
would you rate his/her professional appearance, i.e. dress, hygiene,
etc.?
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How
you rate his/her medical care of your child? |
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How
would you rate his/her friendliness? |
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Were your billing questions answered clearly and politely? |
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Were
you and your child treated professionally by us? |
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What
overall grade would you give us? |
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Any specific comments for specific
people?
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Please enter your additional comments in the
space provided beloe:
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You may remain anonymous, or you can tell us
who you are and how to get in touch
with you (if needed):
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Please contact me as soon as possible regarding this matter.
THANK
YOU!
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