Satisfaction Survey Satisfaction Survey - Post Admission Please enable JavaScript in your browser to complete this form. - Step 1 of 4Survey Code *Please enter the code on the invitation you received.NextDemographicsNameFirstLastLeave blank to submit this report anonymously.I am the... *Hospice PatientSpouse of the Hospice PatientFamily Member of the Hospice PatientFriend of the Hospice PatientAnswer not providedOverall Satisfaction with Hospice ExperienceYour Experience *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Overall, how would you rate your experience with Savior Hospice & Palliative Care?How can we improve?We're sorry to hear that you did not have a good experience. Please let us know how we can do better.NextSurvey CriteriaNextDid the hospice team explain the plan of care to you in a way that you could understand?YesNoHospice team did not explain plan of care to meWhile under the care of hospice, was there always one nurse who was identified as being in charge of the patient’s overall care? YesNoIs there anything else that you would like to tell us about the care provided by the hospice team?Please contact mePlease have a member of the Hospice Leadership Team contact me regarding this survey.Please provide a telephone number where you can be reachedMessageSubmit
