Exit this survey Medical Home Survey - Middleboro Pediatrics Question Title * 1. My child's primary care provider(PCP) has asked me to share with him/her my knowledge and expertise as the parent or caregiver of a child with special healthcare needs. Yes No Question Title * 2. My child's PCP has asked me how my child's condition affects our entire family. Yes No Question Title * 3. My child's PCP understands how my child's medical, behavioral, or other conditions affect his/her day-to-day life. Yes No Question Title * 4. The office staff/nursing staff understands how my child's medical behavioral, or other conditions affect his/her experience in the office. Yes No Please Comment: Question Title * 5. My PCP and/or care coordinator: Yes No a. Help develop a healthcare plan for my child. a. Help develop a healthcare plan for my child. Yes a. Help develop a healthcare plan for my child. No b. Use a care plan to help follow my child's progress. b. Use a care plan to help follow my child's progress. Yes b. Use a care plan to help follow my child's progress. No c. Review and update the care plan with me regularly. c. Review and update the care plan with me regularly. Yes c. Review and update the care plan with me regularly. No Please Comment: Question Title * 6. In the last 12 months, how much of a problem was it to get rehabilitation/therapeutic services or medical equipment for your child? 1 = somewhat difficult 2 = very difficult 3 = unable to obtain Please Comment: Question Title * 7. What does your child need that you are not currently receiving? Question Title * 8. Are you interested in participating in a parent support group relevant to your child's medical/behavioral/emotional condition? Yes No Question Title * 9. Please add any further comments below that would be valuable feedback for improving your child's care and experience in our office. Question Title * 10. (Optional) Please provide your child's name in the box below. Done