Please help us improve our service by taking a few minutes to complete this survey. Western Wake Pediatrics welcomes your feedback and will respect your privacy, as your answers will be kept confidential. Thank you for your participation.

General Patient Information

* 1. In general, what is the quality of your health?

* 2. How would you rate our concern for your privacy?

* 3. How often have you visited Western Wake Pediatrics, P.A. within the year?

Scheduling Your Appointment

* 4. Did you schedule an appointment by phone or did you drop in?

* 5. Did you have to wait longer than expected to get scheduled?

* 6. How easy was it to make an appointment by telephone?

* 7. How long did you wait to speak to a scheduling staff member?

* 8. Was the person who scheduled your appointment courteous and helpful?

* 9. If you were seeking a referral to a specialist, was your request handled in a timely manner?

Day of Your Appointment

* 10. How would you rate the courtesy of the staff at the reception desk?

* 11. How long did you wait in the reception area beyond your scheduled appointment time?

* 12. Which departments(s) did you visit during your appointment?

The Nursing Staff

* 13. How would you rate the competence of the nurse who helped you?

* 14. How would you characterize the concern that the nurse showed for your problem?

* 15. Did the nurse respond to your requests within a reasonable period?

The Provider

* 16. Were you able to see the provider of your choice?

* 17. Did you feel that your provider spent an adequate amount of time with you?

* 18. Mark the boxes that characterize the demeanor of your provider.

* 19. How would you rate the competence of your provider?

* 20. Did you feel that your provider's examination was thorough?

* 21. How well did your provider include you in healthcare decisions?

* 22. Were your questions answered to your satisfaction?

* 23. Would you recommend this facility and its staff to your family and friends?

The Lab Staff

* 24. How would you rate the professionalism and competence of the person who took your blood and worked on your lab exam?

* 25. If you received a lab exam or test, please indicate the type(s) of lab you received:

* 26. If you received a lab exam, was the service prompt, comfortable, and courteous?

Lactation Counseling

* 27. If you met with the lactation consultant and your infant was referred to any of the following specialists, did the referral service improve your breastfeeding experience?

  N/A Definitely Improved Somewhat Improved No Difference Worsen the Experience
Feeding Specialist