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* 1. Who is completing this survey?

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* 2. Your experience was at which Huron Health System Facility?

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* 3. Do you feel that there was good communication about your care between doctors, nurses and other hospital staff?

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* 4. During this hospital stay, did you get all of the information you needed about your condition and treatment?

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* 5. Did you get the emotional support you needed to help you with any anxieties, fears or worries you had during this hospital visit?

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* 6. Were you involved as much as you wanted to be in decisions about your care and treatment?

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* 7. Were you able to get a member of the hospital staff to help you when you needed attention?

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* 8. Before you left the hospital, did you have a clear understanding about all of your prescribed medications, including those you were taking before your hospital stay?

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* 9. Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital?

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* 10. While in the hospital, did your doctor, midwife, or nurse answer your questions about your childbirth in a way you could understand?

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* 11. While in the hospital, were you given enough information about what to expect about your physical recovery after the birth?

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* 12. Were you given enough information about any emotional changes you might experience after the birth?

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* 13. While in the hospital, did your doctor, midwife, or nurse discuss different options for pain control during the labour and delivery with you?

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* 14. Overall, was your pain well controlled? Please answer on a scale where 0 is "Not controlled at all" and 10 is "Controlled completely"

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* 15. While in the hospital did you get enough information about caring for your baby?

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* 16. While in the hospital, did you get enough information to support your decision to breast or bottle feed your baby?

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* 17. While in the hospital, did doctors, midwives, or nurses give you the assistance and support you needed to help you breast feed your baby?

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* 18. Newborn screening is a blood test done shortly after birth to test for treatable diseases that are not usually apparent in the newborn period. While in the hospital, were you offered a newborn screening test for you baby?

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* 19. While in the hospital, did you get enough information about caring for yourself?

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* 20. After the birth of your baby, were other family members or those close to you able to stay with you as much as you wanted?

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* 21. While in the hospital, did doctors, midwives or nurses respect your wishes for labour and delivery in the care that was provided?

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* 22. Before you left the hospital, did hospital staff tell you what symptoms to watch for in your baby?

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* 23. Before you left the hospital, were you given enough information about support services available in your community for you and your baby?

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* 24. Before you left the hospital, did you get enough information from hospital staff about appointments and tests you and your baby needed after you left the hospital?

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* 25. Did your prenatal care prepare you for your labour and delivery at the hospital?

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* 26. Was this your first childbirth experience?

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* 27. What is your feedback about the AMGH Pregnancy Information Booklet?

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* 28. Overall...(Please pick a number)

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* 29. What else would you like to say about this inpatient experience? (Please do not include any names, contact information, or identifying information)

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* 30. Is there a staff member or group that you would like to recognize for providing exceptional care or service?

If you have any immediate questions or concerns regarding your experience with us, please contact our Patient Relations Office using the contact information below.

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