Harbor Pediatrics Medical Group
Exit this survey
How was your visit?
1
. What type of visit was this?
What type of visit was this?
Well
Sick
2
. Who was your Medical Assistant today?
Angelina
Muriel
Vanessa
None of the above
I don't know
Who was your Medical Assistant today?
3
. Who was your Pediatrician today?
Dr. Eugene Chen
Dr. Amy Lau
Dr. Hilda Mendoza
Dr. David Michelis
Who was your Pediatrician today?
4
. Is this your regular primary Pediatrician?
Is this your regular primary Pediatrician?
Yes
No
5
. How easy was it for you to make your appointment?
For example: Phone wait time, appointment availability etc...
How easy was it for you to make your appointment?
For example: Phone wait time, appointment availability etc...
Very Frustrating
Somewhat Difficult
Average
Fairly easy
Effortless
Additional Comments:
6
. How professional and responsive was our Front Office Staff?
For example: Smooth check in, friendly tone, and professionalism.
How professional and responsive was our Front Office Staff?
For example: Smooth check in, friendly tone, and professionalism.
Very Disappointing
Somewhat Unprofessional
Average
Very Professional
Spectacular
Additional Comments:
7
. How long was your wait time in the waiting room?
0-15 Minutes
16-30 Minutes
31-45 Minutes
46-60 Minutes
>60 Minutes
How long was your wait time in the waiting room?
8
. What is your overall satisfaction with our Medical Assistants?
For example: Friendly, courteous, responsive to your needs and professional.
What is your overall satisfaction with our Medical Assistants?
For example: Friendly, courteous, responsive to your needs and professional.
Very Disappointed
Slightly Unsatisfied
Satisfied
Very Satisfied
Excellent
Additional Comments:
9
. How long did you wait in the exam room before your MD saw you?
0-15 Minutes
16-30 Minutes
31-45 Minutes
45-60 Minutes
>60 Minutes
How long did you wait in the exam room before your MD saw you?
10
. Are you satisfied that your MD addressed all of your questions and concerns?
Are you satisfied that your MD addressed all of your questions and concerns?
Not Answered At All
Some Questions Remain Unanswered
Satisfied
All Questions Answered
Excellent
Additional Comments:
11
. Did the MD spend adequate time with you today?
Did the MD spend adequate time with you today?
Very Rushed
Somewhat Short
Just Right
Spent Extra Time
Too Much Time
Additional Comments:
12
. Please comment if you interacted with our Phone Nurse, Office Manager, or billing service.
Please comment if you interacted with our Phone Nurse, Office Manager, or billing service.
Thank you very much for taking the time to complete our survey. Your feedback is very valuable to us.
-Harbor Pediatric Medical Group
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