Home Patients Patient Satisfication Qestionnaire

Patient Satisfication Qestionnaire

The Health Services Authority is committed to providing you with the best possible service during your visit to our facility. We appreciate your answers and comments, which will assist us as we continue to improve the service we offer.

(Tick where appropriate)
Date: 10-Mar-2010

1. Which of our services did you use today?

(for multiple selection, press and hold CTRL key on your keyboard and use your mouse to click the items you want to select.)

2. Was the service you received from our staff today caring and helpful?
Strongly Agree Agree Disagree Strongly Disagree

3. Was your/your relative’s room comfortable during your/his/her stay on the unit?
Strongly Agree Agree Disagree Strongly Disagree

If not, why?

4. Do you feel that you received the information you needed and/or that we adequately answered your questions?
Strongly Agree Agree Disagree Strongly Disagree


5. How would you rate our patient appointment system?
Extremely Satisfied 1 2 3 4 5 Extremely Dissatisfied

 

6. Is there any area of our service where you think there could be improvement?

Yes No

7. Prior to discharge, did you/your relative receive information about:

8. Overall how satisfied were you with your/your relative’s visit?
Extremely Satisfied 1 2 3 4 5 Extremely Dissatisfied


Suggestions:

 

Thank you for completing this questionnaire. The information gathered is confidential and will help us to improve the care we deliver.