* 1. How recently have you or a family member received care at Pembroke Regional Hospital?

* 2. How would you rate the quality of the care at Pembroke Regional Hospital?

* 3. How likely is it that you would recommend Pembroke Regional Hospital to a friend or family member?

* 4. How would you rate the customer service provided by our health care team at Pembroke Regional Hospital?

* 5. Do you feel your care or the care of your family member at Pembroke Regional Hospital has been handled in a timely manner?

* 6. Please rank in order of performance from highest (1) to lowest (6) the following:

* 7. What changes would most improve your Pembroke Regional Hospital?

* 8. What is your age?

* 9. What is your gender?

* 10. Please provide the name of the town or city where you live.

* 11. Do you have any comments, questions or concerns?

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