Patient Satisfaction Survey - Community Surgery Center of Glendale

Patient Satisfaction Survey

Patient Satisfaction Survey

Interaction with anesthesia staff:

Anesthesia

Please indicate your level of confidence in the care provided to you by our Surgery Center staff:

CONFIDENCEINCARE

Information and education from the Surgery Center staff:

INFOSURGERYSTAFF

Interaction with front office staff:

OFFICESTAFF

Interaction with operating room staff:

OPERATINGSTAFF

Please rate the cleanliness and appearance of the Surgery Center.

Overall cleanliness:

OVERALLCLEANLINESS

How would you rate your overall Surgery Center experience?

OVERALL

Did you receive the required paperwork before your procedure?

Paperwork

Patient Care Area

Phone call from the nurse before your procedure:

PatientCareArea

Patient Care Area

Phone call from the nurse before your procedure:

PatientCareArea

Post Op Staff

POSTOPSTAFF

How well did the staff protect your dignity and privacy, and ensure your comfort?

PRIVACYANDCOMFORT

Reception Area

Interaction with front office staff:

RECEPTIONAREA

Required paperwork at registration:

REGISTRATION

Interaction with staff before your procedure:

STAFFINTERACTION
 

By filling in the above form you agree to share this information with Community Surgery Center of Glendale. Information will only be used for quality assurance purposes. We take precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline. We will not rent, sell, or share your personal information with outside companies for their promotional use. We will not distribute your personal information to outside parties without your consent. At any time, you may notify Community Surgery Center of Glendale to remove your email or other contact information from further notifications whether by mail, emailing marcom@regalmed.com or by calling 818-357-5000.