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Admission Discharge Notification Survey
in collaboration with Primary Care and Healthy North Coast

1.What is your profession?(Required.)
2.How satisfied are you with the Admission Discharge Notification Pilot?(Required.)
Very satisfied
Satisfied
Neither satisfied or dissatisfied
Dissatisfied
Very dissatisfied
3.What action have you taken as a result of receiving an Admission Discharge Notification?(Required.)
4.Based on your experience to date with Admission Discharge Notification, how acceptable is the quality of the content included in the Mid North Coast ADN?(Required.)
Highly acceptable
Acceptable
Neither acceptable or unacceptable
Unacceptable 
Highly unacceptable
5.If given the choice regarding the Admission Discharge Notification, would you:(Required.)
6.Please indicate your level of agreement or disagreement with each of the following statements:(Required.)
Strongly agree
Agree
Neither agree or disagree
Disagree
Strongly disagree
Admission Discharge Notifications improve the quality of care I can provide
Admission Discharge Notifications enhance our ability to coordinate the continuity of care
Admission Discharge Notifications improve our sharing of patient information amongst providers
Admission Discharge Notifications improve the quality of my decision making
Admission Discharge Notifications reduce the risk to patient safety
Admission Discharge Notifications improve my productivity
7.Please provide any further comments you would like to make regarding the Admission Discharge Notification