Carteret Children's Clinic Patient Survey
1.
Our records show that your child got care from one of our healthcare provider's. Please choose the provider that you received care from.
Margaret Merrick, MD
Loreli Rowe, MD
Kathy Moorehead, MD
Kimberly Jamison, MD
Melanie Johnston, PNP
Kourtney Sloan, PMHNP
Karen McNair, LPC
Bonnie Weeks, FNP
Robin Gillikin, FNP
2.
How long has it been since your most recent visit with your healthcare provider?
Less than 1 month
At least 1 month but less than 3 months
At least 3 months but less than 6 months
At least 6 months but less than 12 months
12 months or more
3.
How long have you been coming to a healthcare provider at our office?
Less than 6 months
At least 6 months but less than 1 year
At least 1 year but less than 3 years
At least 3 years but less than 5 years
5 years or more
4.
In the last 12 months, did you phone your healthcare provider’s office to get an appointment for an illness, injury, or condition that needed care right away? (If no go to # 7)
Yes
No
5.
In the last 12 months, when you phoned your healthcare provider’s office to get an appointment for care you needed right away, how often did you get an appointment as soon as you needed?
Never
Sometimes
Usually
Always
6.
In the last 12 months, did you make any appointments for a check up or routine care with your healthcare provider? (If no go to #9)
Yes
No
7.
In the last 12 months, when you made an appointment for a check-up or routine care with your healthcare provider, how often did you get an appointment as soon as you needed?
Never
Sometimes
Usually
Always
8.
In the last 12 months, when you phoned or messaged the triage nurse during regular office hours, how often did you get an answer to your medical question that same day?
Never
Sometimes
Usually
Always
N/A
9.
In the last 12 months, when you phoned the after hours provider on call , did you get an answer to your medical question as soon as you needed?
Never
Sometimes
Usually
Always
N/A
10.
Wait time includes time spent in the waiting room and exam room. In the last 12 months, how often did you see your healthcare provider within 30 minutes of your appointment time for a sick visit?
Never
Sometimes
Usually
Always
11.
During your most recent visit, did your healthcare provider explain things in a way that was easy to understand?
Yes, definitely
Yes, somewhat
No
12.
During your most recent visit, did your healthcare provider listen carefully to you?
Yes, definitely
Yes, somewhat
No
13.
During your most recent visit, did you talk with your healthcare provider about any health questions or concerns?
Yes
No
14.
During your most recent visit, did your healthcare provider show respect for what you had to say?
Yes, definitely
Yes, somewhat
No
15.
During your most recent visit, did your healthcare provider give you easy to understand information about these health questions or concerns?
Yes, definitely
Yes, somewhat
No
16.
During your most recent visit, did your healthcare provider spend enough time with you?
Yes, definitely
Yes, somewhat
No
17.
Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate your healthcare provider?
10 Best provider possible
9
8
7
6
5
4
3
2
1
0 Worst provider possible
.
10 Best provider possible
9
8
7
6
5
4
3
2
1
0 Worst provider possible
18.
Would you recommend our office to your family and friends?
Yes, definitely
Yes, somewhat
No
19.
During your most recent visit, were the receptionists as helpful as you thought they should be?
Yes, definitely
Yes, somewhat
No
20.
During your most recent visit, did nurses and medical assistant's treat you with courtesy and respect?
Yes, definitely
Yes, somewhat
No
21.
During your most recent visit, did your healthcare provider order a blood test, x-ray, or other test for you? If no skip to question #23.
Yes
No
22.
Did someone from your healthcare provider’s office follow up to give you those results?
Yes
No
N/A
23.
In the last 12 months, how many times did you visit your healthcare provider?
None
1 time
2
3
4
5 to 9
10 or more times
24.
In the last 12 months has your healthcare provider referred you to a
specialist? If no skip to question # 25
Yes
No
25.
Did someone from your healthcare provider's office assist you in
coordinating/scheduling your referral appointment?
Yes
No
N/A
26.
During your most recent visit, did your healthcare provider seem to know the important information about your medical history?
Yes, definitely
Yes, somewhat
No
27.
In general, how would you rate your child's overall health?
Excellent
Very good
Good
Fair
Poor
28.
In general, how would you rate your child's overall mental or emotional health?
Excellent
Very good
Good
Fair
Poor
29.
What is the highest grade or level of school that you have completed?
8th grade or less
Some high school, but did not graduate
High school graduate or GED
Some college or 2-year degree
4-year college graduate
More than 4-year college degree
30.
Is your child of Hispanic or Latino origin or descent?
Yes, Hispanic or Latino
No, not Hispanic or Latino
31.
Is your child male or female?
Male
Female
32.
What is your child's race? Mark one or more.
White
Black or African American
Asian
Native Hawaiian or Other Pacific Islander
American Indian or Alaska Native
Other
33.
Is the healthcare provider you saw, the provider you usually see if you need a physical, want advice about a health problem, or get sick or hurt?
Yes
No
34.
Did someone help you complete this survey?
Yes
No
35.
How did that person help you? Mark one or more.
Read the questions to me
Wrote down the answers I gave
Answered the questions for me
Translated the questions into my language
Helped in some other way
36.
Please leave comments , suggestions or concerns. Thank you!