Survey with your chance to win!

The Children’s Clinic wants to hear from you! Your feedback is important to us.

We are conducting a survey so that we can provide the best possible care for your family.

The survey will take about 10 minutes to complete. 

Each family that completes the survey will be entered to win one of five prizes. Surveys must be completed by May 31, 2022. The drawing will take place June 15, 2022. Please see below for additional rules. 

The Children’s Clinicis a proud member of the Children’s Health Alliance and Children’s Health Foundation, an association of pediatricians that work together to improve children’s health in Oregon and SW Washington. We are working with the Children’s Health Alliance to conduct this survey. 

Your Privacy is Protected. All information that would let someone identify you or your family will be kept private. We will not share your personal information with anyone without your OK. Your responses to this survey are also completely confidential.

Your Participation is Voluntary. You may choose to complete this survey or not. If you choose not to, this will not affect your health care at our clinic. 
If you want to know more about this survey, please contact the clinic manager. 

Prize Drawing Rules: Each family may only be entered into the drawing once. Only parents or guardians of Children’s Health Alliance member practices are eligible to complete a survey and be entered into the drawing. Children’s Health Alliance employees and member practices’ employees are not eligible to win a prize. A patient survey must be completed between April 30 – May 31, 2022 to be eligible for the prize drawing. Winners will be chosen at random from all valid entries. The prize drawing will take place on June 15, 2022. The top prize winner will receive an Amazon Kindle Fire HD 10. Four runners up will have the choice of one $100 Target or Fred Meyer Gift Card. Winners will be notified via email and/or phone within one week of the prize drawing. Winners will have one week after being contacted to claim their prize; if prize has not been claimed after one week, another drawing will occur and a new winner will be selected and notified.



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