How is Akron Children's Hospital Pediatrics Doing?

Thank you for choosing Akron Children's Hospital Physician Associates. We want your visit to your pediatrician's office to be a pleasant one. Our doctors, nurses and office staff are committed to providing quality care and service to you and your child. You and your family are important to us. Please use this form to tell us about your visit:

Date Of Service:


Akron Children's Hospital Physician Associates Office Location:

Your Name:

Patient's Name:

Mailing Address:

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Telephone (Day):

Telephone (Evening):

Please Rate:

The overall medical care your child received:
Exceeded my expectations
Met my expectations
Did not meet my expectations

The overall quality of service received:
Exceeded my expectations
Met my expectations
Did not meet my expectations

Please comment specifically on the following:

My phone call was answered promptly:

I scheduled an appointment easily at a convenient time:

The front desk staff was helpful and courteous:

Test results were shared in a timely manner:

The office was clean and well-maintained:

Would you recommend our services to a friend?

(Please comment below on any "no" responses)

The information you provide on this form will be confidential and used only to improve and enhance our services.

Please be aware that normal e-mail is not encrypted. Active seekers may be able to read e-mail that you send to us and we send you. If you request information from us via e-mail, you are authorizing us to respond to you with an unencrypted e-mail message that may contain private information. While we are responsible for the privacy of messages that we store on the network, we cannot be responsible for the privacy of those messages once we transmit them to you.

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Contact Us

330-543-1000 (operator)

(8 a.m.-4:30 p.m.)


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