Patient Feedback In our effort to always improve the quality of our services, we would like to know about your recent experience at The Children's Medical Center. This form must be completed by the parent/guardian or patient over the age of 18. The information gathered in this form will only be used for quality improvement purposes. Date of Visit?* Patient's Name* First Last Which CMC office did you visit?*GreenvilleGreerPowdersvilleSimpsonvilleWhich doctor did your child see?*G. Allen Bass, M.D.E. Randy Butler, M.D.Lauren N. Cates, NPWilliam M. Darby, M.D.Mark DeMoss, M.D.Raymond W. Flanders, M.D.Hillary Humphries, M.D.Shannon N. James, M.D.Jeanette Johnson-Watts, LMSCMichelle S. Lynch, M.D.Linda S. Parker, M.D.Michael R. Rupp, M.D.Patricia T. Sanders-Reid, M.D.Laura K. Whitney, M.D.Will Glenn, M.D.Your experience before your visit...Please rate the following.Ease in getting through to us by phone*ExcellentGoodPoorDoes Not ApplyCourtesy of staff*ExcellentGoodPoorDoes Not ApplyConvenience of office hours*ExcellentGoodPoorDoes Not ApplyEase in seeing the doctor of your choice*ExcellentGoodPoorDoes Not ApplyEase in seeing the doctor of your choice*ExcellentGoodPoorDoes Not ApplyEase of use of our website*ExcellentGoodPoorDoes Not ApplyEase of use of our Patient Portal*ExcellentGoodPoorDoes Not ApplyYour experience during your visit...Please rate the following.Ease in locating our office*ExcellentGoodPoorDoes Not ApplyCourtesy of Patient Service staff*ExcellentGoodPoorDoes Not ApplyCourtesy of nursing staff*ExcellentGoodPoorDoes Not ApplyCleanliness of waiting areas/exam rooms*ExcellentGoodPoorDoes Not ApplyWaiting time*ExcellentGoodPoorDoes Not ApplyAmount of time doctor spent with you*ExcellentGoodPoorDoes Not ApplyDoctor's explanation of your child's illness/treatment*ExcellentGoodPoorDoes Not ApplyDoctor's personal manner (courtesy, respect, sensitivity)*ExcellentGoodPoorDoes Not ApplyDoctor's instructions regarding medications & follow-up*ExcellentGoodPoorDoes Not ApplyOverall quality of care your child received*ExcellentGoodPoorDoes Not ApplyWas your child given enough privacy?*ExcellentGoodPoorDoes Not ApplyLikelihood that you would recommend us to a friend or relative?*ExcellentGoodPoorDoes Not ApplyDo you have any suggestions to help us improve your next experience with Children's Medical Center?Name*Email* Please include your name and email address so that we may contact you to learn more about your experience. Your responses will only be used for quality improvement purposes. This iframe contains the logic required to handle AJAX powered Gravity Forms.