* 1. At your most recent visit, how helpful was our staff?

* 2. How well do you feel that our company understands your needs?

* 3. How easy is it for you to schedule appointments at our office?

* 4. How helpful are our office hours?

* 5. How quickly do you receive return calls from our practice?

Poorly Acceptable
i We adjusted the number you entered based on the slider’s scale.

* 6. How long do you have to wait for information regarding a referral?

* 7. Do you feel that your provider helps you manage your child's health?

* 8. At your most recent appointment was your nurse friendly and helpful?

* 9. During your most recent visit did you find your check-in and check-out experience pleasant?

* 10. Do you feel that our patient services team members were knowledgeable regarding your explanation of charges and collecting your payment?

T