The information will be most useful if you answer all questions.
An asterick * means information must be provided.
Your information will be managed in accordance with our
Privacy Policy
If you have any questions regarding this form, please
contact us
Patient Satisfaction Survey
PRE-ADMISSION
Did you find the Rodney Surgical Centre easily?
Excellent
Very Good
Good
Fair
Poor
Was Rodney Surgical Centre itself welcoming?
Excellent
Very Good
Good
Fair
Poor
ADMISSION
Upon arrival reception staff were?
Excellent
Very Good
Good
Fair
Poor
Information provided to you by RSC prior to procedure was?
Excellent
Very Good
Good
Fair
Poor
Did you feel your questions were answered clearly?
Yes
No
Unsure
YOUR CARE
The nurses were:
Friendly?
Excellent
Very Good
Good
Fair
Poor
Provided enough information?
Excellent
Very Good
Good
Fair
Poor
Responded to you
Excellent
Very Good
Good
Fair
Poor
The doctors were:
Friendly?
Excellent
Very Good
Good
Fair
Poor
Provided enough information?
Excellent
Very Good
Good
Fair
Poor
Responded to your needs sufficiently?
Excellent
Very Good
Good
Fair
Poor
DISCHARGE
How satisfied were you with the information you received about:
Your recovery at home
Excellent
Very Good
Good
Fair
Poor
Emergency contacts
Excellent
Very Good
Good
Fair
Poor
ENVIRONMENT
How satisfied were you with the:
Bathroom/toilet facilities
Excellent
Very Good
Good
Fair
Poor
How was the temperature of the three areas:
Reception
Excellent
Very Good
Good
Fair
Poor
Pre-admission/Recovery
Excellent
Very Good
Good
Fair
Poor
Theatre
Excellent
Very Good
Good
Fair
Poor
HEALTH & DISABILITY CODE OF RIGHTS
Cultural and Personal Beliefs
Do you believe your cultural and personal beliefs were recognised?
Yes
No
Do you believe your cultural and personal beliefs were met?
Yes
No
WHAT FACTORS INFLUENCED YOUR CHOICE OF RODNEY SURGICAL CENTRE?
GP
Specialist
Past patient
Friend\Family
Media Advertising
Other
When you have completed this form click on the Send button
