Trisomy 21 Survey

1. How many times has your child been seen in the Trisomy 21 clinic?

How many times has your child been seen in the Trisomy 21 clinic? 1

2-5

5-8

8 or more

2. Were the recommendations made during your visit clearly explained?

Were the recommendations made during your visit clearly explained? Yes

If no, please explain.

3. What recommendations did you find most useful?

What recommendations did you find most useful?

4. Did you have any difficulty carrying through with the recommendations?

Did you have any difficulty carrying through with the recommendations? Yes

If yes, in what ways could our program work to help families with similar problems in the future?

5. Were there concerns or recommendations you would have liked to discuss further?

Were there concerns or recommendations you would have liked to discuss further? Yes

If yes, please explain.

6. Were you happy with the structure and flow of your clinic visit?

Were you happy with the structure and flow of your clinic visit? Yes

If no, please explain.

7. There are many health care providers who do an excellent job of providing care to individuals with Down syndrome and their families. Have you worked with any health care providers you would like to recommend to other parents of other individuals with Down syndrome? Names will not be listed publicly, but will be added to referral list held in the office.

There are many health care providers who do an excellent job of providing care to individuals with Down syndrome and their families. Have you worked with any health care providers you would like to recommend to other parents of other individuals with Down syndrome? Names will not be listed publicly, but will be added to referral list held in the office.

8. On a scale from 1-10 (1 being extremely dissatisfied and 10 being completely satisfied), how would you rate your overall experience in the Trisomy 21 Program at The Children’s Hospital of Philadelphia?

On a scale from 1-10 (1 being extremely dissatisfied and 10 being completely satisfied), how would you rate your overall experience in the Trisomy 21 Program at The Children’s Hospital of Philadelphia? 1

9. Are there any other recommendations/suggestions you feel would improve a family’s experience during a clinic visit in the Trisomy 21 Program?

Are there any other recommendations/suggestions you feel would improve a family’s experience during a clinic visit in the Trisomy 21 Program?

Trisomy 21 Survey - 2013