Surgical Services Patient Feedback Form

Please rate the following questions regarding your experience at BGH:

Prior to my visit, I received all of the information I needed (e.g. how to prepare for my procedure) *

I knew where to go when I arrived at the Hospital *

I felt welcomed and respected as a patient throughout my visit. *

My privacy/confidentiality was respected at all times. *

My surgery/procedure was explained to me in a way that I could understand. *

My anesthesia was explained to me in a way that I could understand. *

I was given clear discharge instructions (e.g. dietary or physical restrictions, new medications, symptoms to watch for, etc.) to be able to manage post-operatively at home. *

My questions were answered promptly and in a way that I could understand. *

I found the patient area to be comfortable and pleasant. *

The Surgical Services area, and the Hospital in general, was clean. *

Using any number from 0 to 10, where 0 is the worst care possible and 10 is the best care possible, what number would you use to rate your care during your Surgical Services visit? *