PATIENT SATISFACTION SURVEY (Please check how well you think we are doing in the following areas)

      Please select which office you currently visit with your child(ren):

        Brooklyn Staten Island Both

          PATIENT CARE

• Ability to get an appointment

  GREAT GOOD OK FAIR POOR
  
  

• Office Hours

  GREAT GOOD OK FAIR POOR
  
  

• Prompt return on calls

  GREAT GOOD OK FAIR POOR
  
  

• How useful do you find our patient handouts?

  GREAT GOOD OK FAIR POOR
  
  

• Comments

  WAITING

  
  

• Time in waiting room

  GREAT GOOD OK FAIR POOR
  
  

• Time in exam room

  GREAT GOOD OK FAIR POOR
  
  

• Comments

  PHYSICIANS
  

• Listens to you

  GREAT GOOD OK FAIR POOR
  
  

• Takes enough time with you

  GREAT GOOD OK FAIR POOR
  
  

• Explains what you know

  GREAT GOOD OK FAIR POOR
  
  

• How comfortable are you with seeing any physician in our practice?

  GREAT GOOD OK FAIR POOR
  
  

• How would you rate the advice/guidance you are receiving from the physicians?

  GREAT GOOD OK FAIR POOR
  
  

• Comments

  NURSES AND MEDICAL ASSISTANTS
  

• Friendly and helpful to you

  GREAT GOOD OK FAIR POOR
  
  

• Answers your question

  GREAT GOOD OK FAIR POOR
  

• Comments

  FRONT DESK
  

• Friendly and helpful to you

  GREAT GOOD OK FAIR POOR
  
  

• Answers your questions

  GREAT GOOD OK FAIR POOR
  
  

• Forms/referrals/authorization requests are done in a timely & efficient manner

  GREAT GOOD OK FAIR POOR
  
  

• Comments

  BILLING DEPARTMENT
  

• Friendly and helpful to you

  GREAT GOOD OK FAIR POOR
  
  

• Answers your questions

  GREAT GOOD OK FAIR POOR
  
  

• Comments

  FACILITY
  

• Neat and clean

  GREAT GOOD OK FAIR POOR
  
  

• Comfort and Safety while waiting

  GREAT GOOD OK FAIR POOR
  
  

• Comments

  ANSWERING SERVICE
  

• Friendly and helpful to you

  GREAT GOOD OK FAIR POOR
  
  

• Response Time

  GREAT GOOD OK FAIR POOR
  
  

• Did you ever have to call more than once to get a response from the physician?

  YES NO
  
  

• Did you ever have trouble getting through to the answering service?

  YES NO
  
  

• Comments

  WEBSITE
  

• How useful do you find our website?

  GREAT GOOD OK FAIR POOR
  
  

• What do you find most useful on our website?

  
  
  

• Would you be interested in accessing your child’s medical records through our website?

  YES NO
  
  

• Comments

  OVERALL
  

• Would you recommend our practice to others?

  GREAT GOOD OK FAIR POOR
  
  

• What is your overall rating of our practice?

  GREAT GOOD OK FAIR POOR
  
  

• Comments