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* 1. Please choose your clinic location

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* 2. Survey completed by:

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* 3. Prior to my visit, I received all of the information I needed (e.g., how to prepare for my appointment)

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* 4. I knew where to go when I arrived at the hospital

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* 5. I felt welcomed and respected as a patient throughout my visit

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* 6. My privacy / confidentiality was respected at all times

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* 7. Any diagnosis / treatment / procedure was explained to me in a way that I could understand

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* 8. I was given clear discharge instructions (e.g., dietary or physical restrictions, new medications, symptoms to watch for, etc.,) to e able to manage my condition at home

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* 9. My questions were answered promptly and in a way I could understand

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* 10. I found the patient area to be comfortable and pleasant

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* 11. The Clinic area, and the hospital in general, was clean

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* 12. Overall impression of the quality of care you received:

0 5 10 (best)
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i We adjusted the number you entered based on the slider’s scale.

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* 13. Comments:

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