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Crown Colony Pediatrics Survey
Thank you for taking a few minutes to complete our survey so we can improve your experience with us!
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1.
How recently were you/child seen in the office?
Less than a week
1 week - 4 months
4 -6 months
6 months - 1 year
Greater than a year
2.
Whom did you see in the office at your most recent visit?
Dr. Angus
Dr. Brzozowska
Dr. Corkins
Dr. Natkin
Dr. Urguhart
Kelly Pearson
3.
Please rate your most recent visit with us:
Scheduling appointments
Excellent
Good
Fair
Poor
Comments
4.
Please rate your most recent visit with us:
Check in
Excellent
Good
Fair
Poor
Comments
5.
Please rate your most recent visit with us:
Wait time
Excellent (less than 5 minutes)
Good (less than 10 minutes)
Fair (10-15 minutes)
Poor (greater than 15 minutes)
Comments
6.
Please rate your most recent visit with us:
Nursing Support
Excellent
Good
Fair
Poor
Comments
7.
Please rate your most recent visit with us:
Check out
Excellent
Good
Fair
Poor
Comments
8.
How would you rate your overall experience with us on your recent visit?
Excellent
Good
Fair
Poor
9.
If we were excellent, how did we excel if not how can we improve?
10.
Contact Info
Name
Email Address
Phone Number
Current Progress,
0 of 10 answered