We would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.

Please select how well you think we are doing in the following areas:

Please select which office you currently visit with your child(ren):
1 - Brooklyn 2 - Staten Island 3 - Both
Ease of Care
Ability to get in to be seen:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Prompt return on calls:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Hours Office is open:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Waiting
Time in waiting room:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Time in exam room:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Waiting for tests to be performed:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Waiting for test results:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Staff
Physicians
Listens to you:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Takes enough time with you:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Explains what you want to know:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Gives you good advice and treatment:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Nurses and Medical Assistants
Friendly and helpful to you:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Answers your questions:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Front Desk
Friendly and helpful to you:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Answers your questions:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Payment
What you pay:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Explanation of charges:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Collection of payment/money:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Facility
Neat and clean building:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Comfort and Safety while waiting:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Privacy:
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Confidentiality
Keeping my personal information private :
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
The likelihood of referring your friends and relatives to us: :
5 - Great 4 - Good 3 - OK 2 - Fair 1 - Poor
Do you consider this center your regular source of care? :
Yes
What do you like best about our office? :
What do you like least about our office? :
Suggestions for improvement? :
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Thank you for completing our Survey