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Telemedicine Children Survey
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TELEMEDICINE CHILDREN SURVEY
Date of Visit
Location Visited
Telemedicine
Were you able to talk to a care provider in a timely manner?
Yes, definitely
Yes, mostly
Yes, somewhat
No
Was the arrangement of the appointment for Video/Phone Consult convenient?
Yes
No
Was this method of connecting with a care provider easy to use?
Yes, definitely
Yes, mostly
Yes, somewhat
No
Was the quality of the video or call good enough?
Yes, definitely
Yes, mostly
Yes, somewhat
No
Was the Video/Phone Consult good value for money?
Yes, definitely
Yes, mostly
Yes, somewhat
No
Did you get information about what symptoms or health problems to look out for after your child left the hospital?
Yes, definitely
Yes, mostly
Yes, somewhat
No
Were you taught all you needed to know about how to care for your child at home?
Yes, definitely
Yes, mostly
Yes, somewhat
No
How often did the doctor treat you with courtesy and respect?
Always
Usually
Sometimes
Never
How often did the doctor listen carefully to you?
Always
Usually
Sometimes
Never
How often did the doctor explain things in a way you could understand?
Always
Usually
Sometimes
Never
How often did you have confidence and trust in the doctor treating your child?
Always
Usually
Sometimes
Never
How often were you given enough input or say in your child’s care?
Always
Usually
Sometimes
Never
How often do you think that staff worked well and in an age-appropriate manner with your child?
Always
Usually
Sometimes
Never
How often did you and your child have enough privacy?
Always
Usually
Sometimes
Never
How often was the doctor fully aware of your child's important medical information?
Always
Usually
Sometimes
Never
Did you know what to do if you had more questions afterwards?
Yes, definitely
Yes, mostly
Yes, somewhat
No
Was the process for collection of medications was simple and convenient?
Yes
No
Would you recommend KKH to your friends and family?
Definitely yes
Probably yes
Probably no
Definitely no
Would you prefer Video/Phone Consult than face-to-face Clinic Consult?
Definitely yes
Probably yes
Probably no
Definitely no
Is there anything else you would like to say about the care your child received in KKH? Are there any of our staff or volunteers you would like to compliment?
Name of Patient
NRIC/Birth Cert No.
Contact Name 1
Contact No.
May someone from the hospital contact you if they have any additional questions about the care you received?
Yes
No
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11/2/2021 12:29 PM
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