Paediatric Visit Parent Feedback
The visit through a parent's eyes: child comfort, communication, and confidence at home.
4 questions · 1 page · about 2 minutes to answer · fully editable after you start
Paediatric care has two patients: the child on the table and the parent doing the worrying. This survey measures the parts parents grade – how the clinician engaged the child, whether concerns were taken seriously rather than reassured away, and whether the parent left confident about what to watch for and do at home.
The left-confident question predicts the anxious call-backs and unnecessary re-visits; a two-minute what-to-expect conversation at the end of the visit moves it more than anything else in the clinic.
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Page 1
Your child's visit
This survey is about your child's recent visit. Tell us how the appointment went for you and your child, so we can improve care for other families. It takes about 2 minutes. This form is not an emergency service. If you need urgent medical help, call your local emergency number.
Q1.How would you rate each part of your visit?*
| Poor | Fair | Good | Excellent | Not applicable | |
|---|---|---|---|---|---|
| How the clinician engaged your child | |||||
| Taking your concerns seriously | |||||
| Explaining things clearly | |||||
| The wait with a child in tow |
Q2.Did you leave knowing what to watch for and when to come back?*
- Completely clear
- Mostly
- Not really
Q3.How comfortable was your child during the visit?
Q4.What would make visits easier for your family?