Meet & Greet Follow-Up — Family (Form MG-01F)
Tell us how the meet & greet felt and whether you’d like this nurse to work with your child.
Thank you for welcoming our nurse. Your comfort matters, and this is a two-way decision — you decide whether you'd like this nurse to work with your child. Please tell us how the visit felt. This takes about two minutes.
Visit details
Child’s name or initials
*
Your name
*
Nurse’s name
*
Date of meet & greet
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Where did you meet?
Please Select
Our home
School
Video or phone call
Other
Your experience
Would you like this nurse to work with your child?
*
Yes
Undecided
No
How comfortable did you and your child feel with the nurse?
1
2
3
4
5
Did the nurse listen and explain things clearly?
Yes
Somewhat
No
Did the nurse seem confident and capable with your child's care?
1
2
3
4
5
Did your child seem at ease with the nurse?
Yes
Somewhat
No
Not applicable
Was the nurse professional, respectful, and on time?
Yes
Mostly
No
What did you like?
Any concerns?
What questions do you still have — about the nurse or the next steps?
Overall, how was the meet & greet?
1
2
3
4
5
Staying in touch
Best phone number to reach you
Please enter a valid phone number.
Format: (000) 000-0000.
How would you prefer we follow up?
Phone call
Text message
Email
No follow-up needed
Thank you! Someone from our office will be in touch shortly. Questions in the meantime? AccuCare Nursing & Home Care, 20 Old Turnpike Rd, Ste 307, Nanuet, NY. 845-624-0260. Office@accucarenursing.com
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