Head & Neck Surgeon, Satisfaction Survey

Month and Year*

Have you been satisfied with the health services provided in this facility?*

Did you have adequate explanations from medical staff regarding treatment?*

Was your privacy protected?*

Were the staff friendly? *

Did the environment appear safe? *

Were your cultural needs met? *

Were you provided with adequate post-operative instructions? *

Were you informed of your rights? *

How accessible was this facility to you? *

Please rate our overall performance?*

Did you get an appointment in an acceptable tie-frame? *

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