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Patient Feedback Survey for Lactation Practice
1.
What location were you see in?
Easton, MD
Camden, DE
Wilmington, DE
Newark, DE
In-Home
Virtual
Other
Other (please specify)
2.
How would you rate your overall experience with our lactation services?
Excellent
Good
Fair
Poor
3.
Which provider did you see?
Brittanie
Kelly
Suzanna
Caroline
Kesha
Paige
I forget/unsure
I'm not comfortable stating who it was
Other (please specify)
4.
Were you seen more prenatal or postpartum services?
Prenatal
Postpartum
5.
How satisfied are you with the level of care provided by our lactation consultants?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
6.
Was the information provided during your consultation clear and helpful?
Very clear and helpful
Somewhat clear and helpful
Neutral
Somewhat unclear and unhelpful
Very unclear and unhelpful
7.
How likely are you to recommend our lactation services to other new parents?
Very likely
Somewhat likely
Neutral
Somewhat unlikely
Very unlikely
8.
What concerns or issues did you encounter during your visit? Select all that apply.
Wait time
Consultation duration
Staff professionalism
Clarity of information
Facility cleanliness
Other
9.
How easy was it to schedule an appointment with us?
Very easy
Somewhat easy
Neutral
Somewhat difficult
Very difficult
10.
Please provide any additional feedback or concerns you have about our services.