Tri-City Pediatric Cardiology Patient Survey

Question Title

* 1. During your most recent visit, were receptionists at our office as helpful as you thought they should be? If not, please provide feedback below

Yes

No

If you answered "No", please provide feedback

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* 2. During your most recent visit, did the nurse(s) portray professional behavior and provide you with proper care? If not, please provide feedback below

Yes

No

If you answered "No", please provide feedback

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* 3. How satisfied were you with the provider you saw?

Extremely satisfied

Very satisfied

Somewhat satisfied

Not so satisfied

Not at all satisfied

Other (please specify)

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* 4. Would you recommend our practice to a friend or family member?

Yes

No

If "No", please explain