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All of us at Middleboro Pediatrics are committed to a continuous effort to improve not only the quality of the medical care we provide, but how well we provide that care. This requires knowing where to direct our attention and efforts.

Please help us improve our services to you by filling out this survey honestly and to the best of your ability. The survey is completely anonymous unless you would like to discuss your comments with us and identify yourself. Thank you for your help.

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1. Which doctor or nurse practitioner did you or your child see during your most recent visit in the office?

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2. What was the reason for your visit?

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3. Was the office staff as helpful as you think they should be ?

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4. Did the office staff treat you with courtesy and respect?

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5. Did your child see his/her regular doctor or nurse practitioner?

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6. Did the doctor or nurse practitioner seem to have all the important information about your child's medical history available?

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7. How would you rate the doctor or nurse practitioner's knowledge about your child as a person (special abilities, concerns, fears)?

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8. Did the doctor or nurse practitioner explain things in a way that was easy to understand?

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9. Did the doctor or nurse practitioner listen carefully to you and your child?

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10. If your child had a health problem, did the doctor or nurse practitioner give you clear instructions about what to do?

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11. Did the doctor or nurse practitioner give you clear instructions about what to do if your child's symptoms got worse or came back?

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12. Did the doctor or nurse practitioner show respect for what you and your child had to say?

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13. Did the doctor or nurse practitioner spend enough time with you and your child?

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14. Was there anything you feel we did particularly well during your visit? If so, please comment.

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15. If you were unhappy with your experience in the office for any reason, please explain why.

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16. Any additional comments or suggestions?

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17. Would you like an email reply to discuss your suggestions or concerns?

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18. Would you like a telephone call to discuss your concerns or suggestions?

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