Patient Online Survey

Please rate the following based on your visit today:

   

   

   

 
Excellent
Poor
Ease of scheduling appointment:

Courtesy of front desk staff:

Courtesy of medical assistant:

The responsiveness of staff:

Waiting time:

Courtesy of Doctor:

Care provided by the Doctor:

Returning your phone calls:

Informing test results:

Assisting with billing/insurance:

Self Management Survey

Rate your understanding of self management goals:

Support received for selected goal:

Did goal seting help your family in making health life style changes:

= four + seven

SG Pediatrics Novi | 26850 Providence Parkway, Suite #320 | Novi, MI 48374 | Phone: 248-662-4091 | Fax: 248-662-0365
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