Have Your Say Patient Experience Thank you for agreeing to participate in this survey about your experience at our hospital. Participation is voluntary and the feedback you provide is anonymous. We value your open and honest feedback and will use your comments to help us to understand what we are doing well and what we need to improve. Your feedback can help us to provide the best possible experience for patients and carers in the future. Question Title * 1. What facility or service are you commenting on? Question Title * 2. Who are you? a consumer / patient a carer / family member a friend Other (please specify) Question Title * 3. Rate the following statement. Great Good Fair Poor Very poor How would your rate your experience? How would your rate your experience? Great How would your rate your experience? Good How would your rate your experience? Fair How would your rate your experience? Poor How would your rate your experience? Very poor Question Title * 4. What did we do well? Question Title * 5. Did you have any areas of concern during your visit? Yes No Question Title * 6. Have you been involved in decisions about your (or your family member's) care as much as you wanted to be? Yes No Question Title * 7. Has the information on your (or your family member's) condition / treatment been easy to understand? Yes No Question Title * 8. Did the doctors, nurses and other health professionals listen to what you had to say? Yes No Question Title * 9. How can we make your experience better? Question Title * 10. Rate the following statement. Great Good Fair Poor Very poor Overall, the quality of the service, treatment or care I received was: Overall, the quality of the service, treatment or care I received was: Great Overall, the quality of the service, treatment or care I received was: Good Overall, the quality of the service, treatment or care I received was: Fair Overall, the quality of the service, treatment or care I received was: Poor Overall, the quality of the service, treatment or care I received was: Very poor Question Title * 11. Are there ways we could improve? Question Title * 12. How do you find information about Darling Downs Health? social media newspaper radio word of mouth website television Healthier Together magazine Other (please specify) Question Title * 13. Any other comments? If you would like to make additional comments you can contact either: Consumer_Liaison_DDHHS@health.qld.gov.au or DDHHS-Consumer-Engagement@health.qld.gov.au Thank you for participating in our survey! Question Title Scan this barcode to complete the survey. (c) Darling Downs Hospital and Health Service, State of Queensland, 2019creativecommons.org/licenses/by/3.0/auToowoomba Health ServicePh 4616 6000 | ABN 64 109 516 141www.health.qld.gov.au/darlingdownsv1.00dl|02/2019 Done
