Dear Parent of PAA Patient,


Please take a few minutes of your time to help us. Below you will find our survey asking you some very important questions about our practice, our staff and our overall care for your child/children. Our goal is to provide comfort, convenience, and satisfaction as well as the very best medical care to all our patients and families. Your comments will help us continue to improve our services, allowing PAA to give the very best medical care possible.

 Please answer the questions honestly and accurately. The survey is two sided, so please remember to answer the questions on the back. Thanks for your time and cooperation! Please return the survey by dropping it off at the office, by mail or by fax. If you prefer, please visit our website where you can fill out and submit the survey online.


Thank you,

Pediatric & Adolescent Associates 

* 1. Why did you choose this practice?   (Choose all that apply.)

* 2. Do you have an office preference?

* 3.

At your last visit which doctor did you see?

* 4.

Who is your preferred doctor to see?

* 5. Were you greeted by front office staff?

* 6. Were you greeted by your nurse?

* 7. Were you pleased with the service you received at your visit? (please explain)

* 8. What aspects of our practice do you like best?

* 9. Please tell us what; if anything we can do to make future visits to our office more pleasant for you and your family?

* 10. Would you recommend our office to a family member or friend?

* 11. Please fill in your contact information if you would like to be contacted by PAA regarding your concerns:

* 12. Before Your Office Visit

  Very Satisfied Satisfied Neither Satisfied nor Dissatisfied Dissatsified Very Dissatisfied
Ease of getting through to the office by phone.
Courtesy of staff taking your call
If you’ve had to leave message for a nurse, your call was returned in a timely manner.
Availability of desired appointment (time, doctor, etc…)
Convenience of office hours.