Integrative Pediatrics, LLC
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How are we doing?

Thank you for taking the time to complete this survey. By doing so, you give us valuable feedback on how we can better serve our patients and address their concerns. Our survey consists of two parts; Reception and Examination. After completing the section on Reception, you will directed to the Examination part of the survey.

Part 1
- Reception and Scheduling

Appointment Date:

Were you greeted courteously on the phone when you made your

While on the phone, was the scheduler/receptionist helpful with all of your needs and questions?

Were we easy to find?

How did you hear about our office?

When you arrived for your appointment, was the receptionist friendly?

Did the receptionist have all the necessary forms ready for you and explain them thoroughly?

Was the waiting room clean and attractive?

Was there adequate seating?

Did you have to wait longer than 15-20 minutes after your paperwork was completed for the nurse to call you back to the exam room?

Was your appointment in the morning or afternoon?:


Integrative Pediatrics, LLC
Phone: 503.643.2100
Fax: 503.643.7300
Advice Nurse: 503.643.2100
Address: 11790 SW Barnes Rd, Blg. A, Suite 140, Portland, Oregon 97225