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* 1. How convenient was the appointment time you were able to get?

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* 2. Hours the clinic is open

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* 3. During your most recent visit, did your healthcare provider spend enough time with you?

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* 4. During your most recent visit, did your healthcare provider listen carefully to you?

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* 5. During your most recent visit, did clerks and receptionists at your healthcare provider’s office treat you with courtesy and respect?

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* 6. During your most recent visit, did your healthcare provider explain things in a way that was easy to understand?

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* 7. Were you  included in the decisions about your child's care

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* 8. Overall, how would you rate the care you received from your provider?

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