Patient Survey

Dear Patient,

Please assist us by taking a few minutes to fill out this survey.

We, the staff of are pleased that you chose our center for your surgical procedure. It is our goal that you have a pleasant experience with excellent care. Your feedback and suggestions are very important to us. Please rate your experience by checking the most appropriate response. Add any comments you would like.

Professional and courteous service of the office staff.

Speed and efficiency of registration.

Answers to financial and insurance questions.

Professional and courteous service of nursing staff.

The nurse and support staff (respiratory, radiology, lab, pharmacy) education and attentiveness to your procedure concerns.

The physicians listen to your questions and concerns.

The care provided by the surgeon.

The care provided by the anesthesia provider.

Quality of written post operation instructions.

Staff gave you the privacy needed.

Cleanliness and comfort of the surgery center.

Was your procedure fully explained to you by your physician?

Discharge instructions explained and easy to understand?

Likelihood that you would recommend Eminent Medical Center to others.

Staff members introduced themselves and kept you informed.

I observed the health care staff using hand cleaner or washing their hands.

The environment felt safe and comfortable.

I would choose to return to this surgery center if needed.

I have no signs of infection following my surgery

Did you have complications following surgery?

Is there anything you can think of that could have improved your experience?

Your Name (Optional)

Today's Date

Surgery Date

Your Surgeon

THANK YOU!

Your comments and suggestions for improvement are welcome and appreciated.

If we can help you, please contact us at 469-910-8800.