Tallgrass Surgery Center: Patient Satisfaction Survey

Please rate the quality of the information and instructions given to you.
 

1. Prior to Surgery
   
2. Regarding Anesthesia:
Risks/complications/choices:
   
3. Prior to discharge (home care):
   
Please rate the level of courtesy and professionalism displayed by the staff:
4. Admissions/Billing
   
5. Pre-Op (Before Surgery)
   
6. O.R. Staff (During Surgery)
   
7. Post-Op (After Surgery)
   
8. Please rate the level of care and personal interest you received from your physician.
   
9. Please rate how your pain was managed.
   
10. Please rate the cleanliness and comfort of the facility.
   
11. Please rate the protection of your privacy.
   
12. Please rate the treatment and courtesy given to your family member/caregiver.
   
13. Please rate the convenience of having your procedure performed at our facility.
   
14. Please rate your overall experience and the care you received.
   
15. Were you notified of your surgery time within 48 hrs?
   
16. Why did you choose our facility? Physician
Insurance
Cost
Other 

17. Please let us know any comments or suggestions you have. What did you like most/least about the facility?

Date of procedure:
   
Name (optional):
   
Surgeon’s name:
   
May we contact you about your comments/concerns?

 

 

 

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