Firefly Patient Feedback Survey
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1
. How many times have you been to Firefly in the past year?
How many times have you been to Firefly in the past year?
0-1
1-2
2-3
3-4
>4
*
2
. Which provider did you see during your most recent visit?
Which provider did you see during your most recent visit?
Dr. Arena
Dr. Barbiero
Dorothea Esposito, APRN
Dr. Senapti
Dr. Silverstein
Dr. Romanowitz
Dr. Zimmerman
Dr. Siegel
*
3
. On a scale of 1-5 how would you rate your experience at Firefly?
On a scale of 1-5 how would you rate your experience at Firefly?
1 Poor
2 Fair
3 Average
4 Good
5 Excellent
*
4
. How long did you wait to see the provider?
How long did you wait to see the provider?
0-15 minutes
15-30 minutes
30-45 minutes
45 min-1 hrs
> 1 hr
*
5
. What day of the week was your most recent visit to Firefly After Hours Pediatrics?
What day of the week was your most recent visit to Firefly After Hours Pediatrics?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
*
6
. Please share your feedback regarding your experience at Firefly.
Your feedback is important to us.
Please share your feedback regarding your experience at Firefly. Your feedback is important to us.
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