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Shelby Pediatrics Patient Satisfaction Survey

What is your satisfaction with the effectiveness of Treatment?
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
What is your satisfaction with the explanation of your medical condition and treatment plan?
Very Dissastisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
What is your overall satisfaction with your most recent visit?
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Please Explain:
What is your satisfaction with the way the medical staff communicated with you?
Very Dissastisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
Please Explain:
How satisfied are you with the amount of time that the medical staff spent with you?
Very Dissatisfied
Dissatisfied
Neutral
Satisfied
Very Satisfied
How Satisfied are you with the amount of time that it took to get in for an appointment?
Very Dissatisfied
Dissatisfied
Neutral
Satsified
Very Satisfied
How would you rate the cleanliness of the facility?
Very Clean
Clean
Average
Below Average
Not Clean
Which aspects of the facility did you find most satisfactory?
Waiting Area Comfort
Signage and Directions
Restroom Cleanliness
Overall Ambiance
How likely are you to recommend our healthcare services to others?
Very Likely
Likely
Neutral
Unlikely
Very Unlikely
What factors influenced your choice of our healthcare facility?
Location
Reputation
Insurance Coverage
Referral from Doctor
Online Reviews
How satisfied are you with the billing and payment process?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
Which communication methods do you prefer for receiving updates or reminders?
Phone Call
Text Message
Email
Postal Mail
How would you rate the professionalism of the medical staff?
Excellent
Good
Average
Below Average
Poor
How comfortable did you feel discussing your health concerns with the doctor?
Very Comfortable
Comfortable
Neutral
Uncomfortable
Very Uncomfortable
Which areas of our service do you think need improvement?
Wait Times
Staff Attitude
Facility Cleanliness
Information Clarity
How satisfied are you with the privacy and confidentiality of your medical information?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
What aspects of our service did you find most helpful?
Friendly Staff
Clear Communication
Efficient Service
Comfortable Environment
How would you describe the demeanor of the nursing staff?
Very Friendly
Friendly
Neutral
Unfriendly
Very Unfriendly
What improvements would enhance your experience at our facility?
Shorter Wait Times
More Parking Spaces
Extended Hours
Additional Specialists
How informed did you feel about the next steps in your care plan?
Very Informed
Informed
Neutral
Uninformed
Very Uninformed
Which factors influenced your decision to choose our facility for treatment?
Reputation
Proximity
Insurance Coverage
Specialist Availability
Referral
How satisfied are you with the follow-up care provided after your visit?
Very Satisfied
Satisfied
Neutral
Dissatisfied
Very Dissatisfied
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