Patient Satisfaction Survey 2021

How Are We Doing?

Question Title

* 1. In the last 6 months, when you contacted our office to get an appointment for care you or your child needed right away, how often did you get an appointment as soon as you needed?

Never

Sometimes

Usually

Always

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* 2. In the last 6 months,how often did this provider explain things in a way that was easy to understand?

Never

Sometimes

Usually

Always

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* 3. In the last 6 months,how often did this provider seem to know the important information about your medical history, or that of your child's?

Never

Sometimes

Usually

Always

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* 4. In the last 6 months,how often were clerks and receptionists at this provider's office as helpful as you or your child thought they should be?

Never

Sometimes

Usually

Always

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* 5. In the last 6 months, if you needed a referral from your primary care provider to see another health care professional, did you get one as soon as you needed it?

Yes

No

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* 6. In the last 6 months, if you needed to visit another health care professional outside of your primary health care provider's office, did someone in your primary care provider's office help you make the appointment?

Yes

No

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* 7. What is your insurance type?

Commercial

Child/Family Health Plus

New York State Medicaid

self pay

other

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* 8. Currently the only COVID 19 vaccine approved for pediatric use (Pfizer) can not be given in most medical offices. When other COVID vaccines become approved for pediatric use, do you wish your child to receive it in our office.

I prefer my child receive his/her vaccinations at his pediatrician.

I prefer my child to receive this vaccine at a pharmacy or urgent care site.

I don't care where my child receives his vaccine, so long as vaccination is safe and effective

I need more information about this subject, and prefer to defer vaccination at the present time.

I do not want my child to receive this vaccine.

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* 9. Do you know where your child 13-20 years of age may presently receive the covid vaccine?

Yes

No