Driscoll Transition of Care Post Survey

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This form is closed. We are not taking new submissions right now.

We appreciate your time and feedback. Please select the box below:*

Your responses are anonymous and will not be shared with your child’s provider. Completion of this survey qualifies you to receive a $20 gift card.

Please select if your child is seen by one of the following:*

You chose "Other", please specify:*

What is your child’s age?

At your child’s last checkup, did the doctor talk about when they should start seeing an adult doctor?*

Did you complete a Transition Readiness Assessment with your doctor at your child’s THSteps visit?*

After you filled out the Transition Readiness Assessment, did the doctor go over your answers with you and your child?*

Did the Transition Readiness Assessment help you understand what transition readiness means?*

Was this the first time you learned that your child will need to see an adult doctor instead of a children’s doctor when they turn 18?*

At this time, do you feel your child will be ready to switch from a pediatric doctor to an adult doctor by the age of 18?*

Thank you for your feedback. On the next screen, you will be asked to securely provide your mailing address for delivery of your $20 gift card.