Client Experience Questionnaire

Tell us about your experience!  Your feedback helps us to improve the way we provide care.  

We do not collect personal information unless you request a follow-up.

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* 1. Location of care received:

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* 2. Discharge Planning Program Specific Questions:

  Yes No N/A
a.  Prior to leaving hospital, did you have a clear understanding of your prescribed medications or medication changes?
b.  Did you receive adequate instruction prior to leaving hospital of what to do if you have concerns with your health condition?
c.  Did staff confirm with you, prior to discharge, that you would have the help needed when arriving home?
d.  Did you have a clear understanding of your discharge instructions?
d(i).  If No, did you feel comfortable asking further questions if needed?
e.  Did you feel involved in your discharge planning?

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* 3. Do you have any suggestions or feedback on how we can improve the discharge planning process?

Demographics: (of the patient) Collected for statistical purposes only to target improvements.

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* 4. Age:

Forward additional concerns or compliments regarding your care to Patient Relations.
Patient Relations:  email    or  call   1-800-735-6596

 Questions or concerns related to this survey can be sent to 

Thank you for your participation!