Your Feedback is Important to Us Please let us know about your hospital stay by completing this short survey. Hospital Unit/ Care Area Overall, how would you rate the care and services you received at our hospital? Excellent Very Good Good Fair Poor Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital? Completely Quite a Bit Partly Not At All If you did not answer "Completely", please tell us what was missing? During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it? Always Usually Sometimes Never N/A During this hospital stay, how often did the staff do everything they could to help you with your pain?? Always Usually Sometimes Never N/A Please share with us: What did we do well? What can we improve? Was there a member of our staff who made your experience excellent? Please tell us his/her name (if known) and tell us how? Optional: Your Name: Telephone: Email: May we share your comments (anonymously)? Yes No Thank you for your feedback!