Greenville Hospital System, University Medical Group
Department of Pediatrics
Patient Satisfaction Survey

We sincerely thank you for your interest in providing us feedback on how were are doing. Before you start, please tell us where you were seen and when:

(Please Select)

Mills Avenue Office (Downtown Greenville)
Maxwell Pointe Office (S. Highway 14 and Woodruff Road)
West Georgia Road (Simpsonville)

Date of the Visit:

  1. Access to Care Excellent Very Good Good Fair Poor  
1.1 Ease of scheduling the appointment
1.2 Courtesy of person who scheduled the appointment
1.3 Our helpfulness on the phone
1.4 Our promptness in returning your phone calls
 
  2. During Your Visit Excellent Very Good Good Fair Poor  
2.1 Speed of the registration process
2.2 Courtesy of staff in the registration area
2.3 Comfort and pleasantness of the waiting area
2.4 Length of wait before going to the exam room
2.5 Comfort and pleasantness of the exam room
2.6 Friendliness/courtesy of the nurse/assistant
2.7 Concern the nurse/assistant showed for your child's problem
and to you:
2.8 Waiting time in exam room before being seen by the care provider
2.9 Did the staff wash/cleanse their hands before providing care? Yes No Unsure    
2.10 Did the staff wash/cleanse their hands after providing care? Yes No Unsure
   
  3. Your Child's Care Provider Excellent Very Good Good Fair Poor  
3.1 Friendliness/courtesy of the care provider
3.2 Explanations care provider gave you about your child's condition
3.3 Concern care provider showed for your questions
3.4 Care provider's efforts to include you in decisions pertaining to your child's treatment
3.5 Information care provider provided you about medications (if any)
3.6 Instructions care provider provided you about follow-up care
3.7 Degree to which care provider talked with you using words you could understand
3.8 Amount of time care provider spent with your child and you
3.9 Your confidence in this care provider
3.10 Likelihood of your recommending this care provider to others
 
  4. Our Facility Excellent Very Good Good Fair Poor  
4.1 Convenience of our office hours
4.2 Overall comfort of facility
4.3 Adequate parking
4.4 Signage and directions easy to follow
   
  5. Overall Assessment Excellent Very Good Good Fair Poor  
5.1 Overall rating of care received during your visit
5.2 Our sensitivity to your needs
5.3 Likelihood of your recommending our practice to others
5.4 Our concern for your privacy
   
  6. Wait Time
6.1 How many minutes did you wait after your scheduled appt time before you were called to the exam room?  1-10 10-20 20-30 30-40 40-50 60+
6.2 How many minutes did you wait in the exam room before you were seen by the care provider?  1-10 10-20 20-30 30-40 40-50 60+
 
  7. Additional Comments

(Optional) Name:

(Optional ) Telephone #:

(Optional) Email:

Would you like a response by telephone or email? Yes   No