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* 1. What date were you seen?

Date of Service

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* 2. Who did you see?

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* 3. Which office did you go to?

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* 4. Please rate the following questions about the service you were provided

  Excellent Good Fair Poor N/A
How was our staff’s service when you first called our office to schedule an appointment?
How was our staff’s service at check-in?
How was our Medical Assistant’s service before seeing the doctor weighing, blood pressure, ECG, etc.)?
How were your wait times?
How was our staff’s service at check-out?
How was our staff’s service when you called with insurance or billing questions?

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* 5. Is there anything we can do to improve your experience with Children’s Heart Center?

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* 6. Did any staff member’s service exceed or fail to meet your expectations?

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* 7. Would you like to be contacted regarding this survey?

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* 8. This patient survey can be anonymous. However if you would like our office to contact you please provide the following information.

Children's Heart Center Nevada appreciates the time you took to respond to our survey. Should you have any questions please do not hestitate to contact our office. Thank you.
 
100% of survey complete.

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