Patient Experience Survey - English

Please help us improve our services to you by sharing your previous experiences in our facility.  Please type your answer in the box below each question, and when you are finished, click on the Submit button at the bottom of the form.  Thank you for your time and input!

Describe your experience when getting an appointment for the date and time you needed.
Describe your experience when you felt listened to and were able to get answers to your questions regarding your child's care.
Describe your experience when you received a referral, changes in your medication, or lab results regarding your child.
Describe your experience when you received advice or help with self-care or making changes in health habits for your child.
Describe an experience you have had with any of our on-site services such as Medicaid, Social Work, Case Management, Asthma Education, Lactation, Interpretation Services, or Healthy Steps.
What challenges might cause you to not show for an appointment?
What can we do to improve the Waiting Room experience?
What can we do to improve the Exam Room experience?
Are there any other experiences you would like to share with us?