* 1. How did you hear about JPA?

* 2. Which Provider did you see at your most recent visit

* 3. Is this the Provider you usually see?

* 4. Doctor Evaluation

  Strongly Agree Agree Not Applicable Disagree Strongly Disagree
Listened carefully to you and your child
Explained things in a way that was easy to understand
Answered all Questions to your satisfaction

* 5. Nurse Evaluation

  Strongly Agree Agree Not Applicable Disagree Strongly Disagree
Listened carefully to you and your child
Explained things in a way that was easy to understand
Answered all questions to your satisfaction

* 6. Office Staff Evaluation

  Strongly Agree Agree No Opinion Disagree Strongly Disagree
Were friendly and helpful to you and your child
Maintained a professional manner
Receptionists were friendly and helpful

* 7. Waiting

  Strongly Agree Agree No Opinion Disagree Strongly Disagree
Time in waiting room was less than 30 minutes
Time in exam room was less than 30 minutes
Time waiting for test result was appropriate

* 8. Have you used our after hours and weekend services?

* 9. Have You Used our Patient Portal Services

* 10. Ease of Getting Care

  Strongly Agree Agree No Opinion Disagree Strongly Disagree
Received appointment at desired time
Return of non-emergency phone calls or Patient Portal Messages was prompt (within 4 hours)
Saw Physician of your choice
Showed concern for you and your child's privacy
Able to get an appointment within a reasonable amount of time (Less than 60 Days) for a Routine visit
Able to get a sick visit appointment with 24 hours

* 11. Would you recommend this office to your family and friends?

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