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Did you have confidence and trust in the doctors and nurses treating you?
Yes No
 

Were the physicians and staff caring and compassionate?
Yes No
 
 

What do you like best about our Emergency Room?
 
 

Very Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied
* How well did the hospital meet your needs as a patient?
Measurement Item 2
Measurement Item 3
 
 
How likely would you be to return to our Emergency Room should you need medical care again?
 
 
 
 
 

Did you have confidence and trust in the doctors and nurses treating you?
Yes No
 
 

Were the physicians and staff caring and compassionate?
Yes No
 
 

 
Yes No
 
 
 
Additional Comments/Suggestions for improvement
   
 
 

Very Satisfied Somewhat Satisfied Neutral Somewhat Dissatisfied Very Dissatisfied
How would you rate the helpfulness of our receptionist?
Measurement Item 2
Measurement Item 3
 

Did you have confidence and trust in the doctors and nurses treating you?
Yes No
 
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