Cardiac Center Parent Survey

1. Cardiac Center Parent Survey

The survey should take about 5 minutes to complete. Please answer all questions that apply; feel free to skip those questions that are not applicable to you. Your feedback is valuable to us. Thank you for your help!
1. How many children in your family have been diagnosed with a heart problem?
2. What are the ages of your children (or child) diagnosed with a heart problem (or your age if you are the patient)?
3. My child/children (or myself if I am the patient)with heart disease (check all that apply):
4. Have you been or are you planning to be evaluated/treated at The Children's Hospital of Philadelphia Cardiac Center?
5. Do you currently see other specialists or generalists at CHOP?
6. When originally diagnosed, where did you first turn to learn more about the condition and possible treatments? (Select all that apply)
7. If you turned to a non-CHOP Web site, which one(s) did you use?
8. What features, information or functions on other sites visited did you find helpful?
9. If you did a keyword search in Google, Yahoo or another search engine, which term(s) did you use?
10. Did the diagnosing physician refer you to specific Web sites to learn more about the condition?
11. List the sites (if any) to which your physician referred you.
12. Have you visited The Children's Hospital of Philadelphia Cardiac Center Web site in the last year (
13. How did you originally find The Children's Hospital of Philadelphia Cardiac Center Web site?
14. Did you see the Children's Hospital Cardiac Center Web site prior to making a treatment decision?
15. If you have used the Cardiac Center Web site, please tell us why (Select all that apply):
16. What were the reasons you chose to make an appointment at The Children's Hospital of Philadelphia? (Select all that apply)
17. How often did you visit The Children's Hospital of Philadelphia Cardiac Center Web site prior to your appointment/evaluation?
18. Please rate the importance of having the following content/features on the Cardiac Center Web site.
1. Very important2. Important3. Somewhat important4. Not very important5. Not at all important
Physician bios
Volumes of surgeries/procedures
Photos, videos
Physician publications
Research information
Clinical trial information
Center news/events
Parent resources
Program size
Program/service descriptions
Patient stories
Make an appointment online
Condition/treatment descriptions
Information on CHOP locations
19. What additional information or functions on the Web site would have been helpful to you when selecting a hospital, when receiving treatment, or after treatment was completed?
Powered by SurveyMonkey
Check out our sample surveys and create your own now!