Patient Survey

This page contains the Children's Clinic Patient Survey form that you may submit electronically.

We value all comments you provide to us.

All information provided will remain confidential.

►Please Note:

• ANY SUBJECT RELATED TO PATIENT CARE must only be discussed in-person or on the phone with our staff and providers by calling (610) 376-8691.
• WE WILL NOT RESPOND to any comment about PATIENT CARE!
• DO NOT use this non-secure online form for any comments or questions about patient care.
• DO NOT include on this non-secure online form any private information such as health insurance policy numbers, social security numbers, etc., that need to be protected by you.
• ANY SUBJECT RELATED TO PATIENT CARE must only be discussed  in person or on the phone with our staff and providers.

Thank you for your input!

 ---> Click HERE and Proceed to Patient Survey form