Your Appointment
Appointments are available within a reasonable amount of time
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Scheduling an appointment is efficient and
convenient
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
The person who took my call was courteous &
professional
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
When I leave a message, it is returned
promptly
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Our Staff
The receptionists were courteous & friendly
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Calls/questions regarding my care are
returned promptly
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Clinical Staff show concern and sensitivity
to my needs
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Billing and financial matters are handled
properly
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
My medical information is discussed and
handled confidentially
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
I am notified promptly of my test results
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Your Visit With The Doctor/Nurse Practitioner
My Doctor/Nurse Practitioner returns my
calls in a timely manner
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
I am given the chance to provide input to
decisions about my healthcare
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Medications and care at home are explained
to me in a way I can follow
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
My Doctor/Nurse Practitioner answers all my
questions
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
My Doctor/Nurse Practitioner gives his/her
full attention to what I am saying
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Our Facility
Ironwood Family Practice has up-to-date
equipment and facilities
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Patient areas are clean and organized
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Parking is adequate
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
The building is clean/well-maintained,
including entrances and grounds
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Your Overall Satisfaction
I would rate the overall quality of care I
received as extremely high
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
I would recommend Ironwood Palouse
Pediatrics
to family & friends
Strongly Agree
Somewhat Agree
Neither Agree of Disagree
Slightly Disagree
Strongly Disagree
Please tell us about yourself
Your age
Under 18
19-30
31-40
41-50
51-60
Over 60
How long have you been a patient at Palouse
Pediatrics?
Less than 1 year
1-5 years
6-10 years
11 or more years
I usually see:
Dr. Burns
Dr. Chambers
Dr. Chisholm
Dr. Emry
Dr. Neal
Mary Duff, ARNP
Ellen Taylor, ARNP
Are there any other suggestions that would improve
our care to you?