Helpfulness of staff members?

3 - Excellent

2 - Good

1 - Fair

0 - Poor

Communication with the staff was timely?

3 - Excellent

2 - Good

1 - Fair

0 - Poor

Questions were answered in a clear, understandable manner?

3 - Excellent

2 - Good

1 - Fair

0 - Poor

Physical environment of our facility?

3 - Excellent

2 - Good

1 - Fair

0 - Poor

To what extent did the unit meet the patient's needs?

3 - Excellent

2 - Good

1 - Fair

0 - Poor

Overall rating of services received?

3 - Excellent

2 - Good

1 - Fair

0 - Poor

Was your patient involved in our Dual Diagnosis program?

Yes

No

Do you feel it was beneficial?

Yes

No

Did you receive the patient's discharge instructions for follow up care?

Yes

No

Did you receive information on the patient's discharge medication list's?

Yes

No

Could we use your comments in our marketing campaign and or website?

Yes

No

Would you recommend our hospital?

Yes

No

Which unit was the Patient located in?

Child

Adolescent

Adult

Geriatric