SHARE 
TEXT SIZE 
Home : Contact Us : Patient Satisfaction Survey

Contact Us

Patient Satisfaction Survey

If you or a loved one recently received services at Meriter Hospital, we would appreciate your feedback on the care you experienced. Your feedback will help us learn what you liked and what we can do to better meet our community's needs.

Please answer the following questions and hit the "submit" button when you have completed the survey. If you would like to receive a reply, please include your contact information.

1. Who received services at Meriter?

Me
Loved One

2. If you had important questions regarding your condition or treatment, were you able to find someone to answer your questions?

Yes, always
Yes, sometimes
No
I didn't have any questions

3. Were the answers the staff provided to your questions presented in a way that you could understand?

Yes, always
Yes, sometimes
No
I didn't have any questions

4. Did you have confidence and trust in the staff that treated you/your loved one?

Yes, always
Yes, sometimes
No

5. How satisfied were you with the courtesy of the staff that treated you/your loved one?

Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied

6. How would you rate the availability of the staff?

Excellent
Very good
Good
Fair
Poor

7. Did you/your loved one feel like you were treated with respect and dignity?

Yes, always
Yes, sometimes
No

8. How would you rate how well the staff worked together?

Excellent
Very good
Good
Fair
Poor

9. Overall, how satisfied were you with the care you/your loved one received at Meriter?

Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied

10. Would you recommend Meriter to your family and friends?

Yes, definitely
Yes, probably
No

11. Which area of Meriter did you/your loved one receive services from? (If you were cared for in the Birthing Center, please note which floor you were on.)

12. Do you have further comments or impressions you would like to share?

13. If you would like a phone call or e-mail to discuss your care more thoroughly, please include your name and contact information below:

Name: Daytime Phone Number: - -

Email: 

 

14. Do you want a Meriter representative to follow-up with you?

Yes
No

15. Please enter the text as it appears below. If you are having a hard time seeing the words that are below, you can refresh the box by clicking on the arrow button in the box to get two new words.