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Lansing Patient Survey
How satisfied were you with your visit?
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* Indicates required question
How
helpful was our staff over the phone?
*
Not Helpful at All
1
2
3
4
5
6
7
8
9
10
Extremely Helpful
How helpful was our nursing team?
*
Not Helpful at All
1
2
3
4
5
6
7
8
9
10
Extremely Helpful
How clearly were financial responsibilities discussed?
*
Not Clearly at All
1
2
3
4
5
6
7
8
9
10
Extremely Clear
How clean was the facility?
*
Not Clean
1
2
3
4
5
6
7
8
9
10
Extremely Clean
How well were your needs met?
*
Not Met at All
1
2
3
4
5
6
7
8
9
10
All Needs Were Met
Additional Comments?
Your answer
How satisfied were you with your care?
*
Very Unsatisfied
1
2
3
4
5
6
7
8
9
10
Extremely Satisfied
How well was your privacy protected?
*
Not at All
1
2
3
4
5
6
7
8
9
10
Very Protected
How likely are you to return to Lansing Surgery Center?
*
Not Likely at All
1
2
3
4
5
6
7
8
9
10
Very Likely
Would you recommend Lansing Surgery Center to others?
Would Not Recommend
1
2
3
4
5
6
7
8
9
10
Definitely Would Recommend
Clear selection
Comments/Suggestions
Your answer
Would you like to be contacted?
Yes
No
Clear selection
Were the anesthetics (pain medication) given, clearly explained?
Not Clearly at All
1
2
3
4
5
6
7
8
9
10
Very Clearly
Clear selection
Was the staff courteous and helpful?
*
Not Helpful
1
2
3
4
5
6
7
8
9
10
Extremely Helpful
Was the nursing staff courteous and helpful?
*
Not Helpful
1
2
3
4
5
6
7
8
9
10
Extremely Helpful
Was the surgeons courteous and helpful?
*
Not Helpful
1
2
3
4
5
6
7
8
9
10
Extremely Helpful
Was the pain level as expected?
*
Not as Expected
1
2
3
4
5
6
7
8
9
10
As Expected
Did you have adequate recovery time at the facility?
*
No Time at All
1
2
3
4
5
6
7
8
9
10
Plenty of Time
How clear and helpful were the home care instructions?
*
Not Clear or Helpful
1
2
3
4
5
6
7
8
9
10
Very Clear and Helpful
Comments/Suggestions
Your answer
Was the business staff courteous and helpful?
*
Not Helpful
1
2
3
4
5
6
7
8
9
10
Very Helpful
How was the wait time?
*
Longer Than Expected
1
2
3
4
5
6
7
8
9
10
Proper Wait Time
Were the sequence of events explained clearly prior to your procedure?
*
Not Clear at All
1
2
3
4
5
6
7
8
9
10
Very Clear
Comments/Suggestions
Your answer
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