Family Room Guest Family Survey
1.
What's Your Name? (Optional)
2.
What's your email? (Optional)
3.
Relationship to patient
Mother
Father
Caretaker
Sibling
Other
Other (please specify)
4.
How did you find out about the Ronald McDonald Family Room?
5.
Overall, how satisfied were you with the Family Room facility? 1 being very unsatisfied and 5 being very satisfied.
Highly dissatisfied
1
2
3
4
5
Highly satisfied
6.
Overall, how satisfied were you with our services (ex: meals, snacks, showers, nap/overnight rooms, living room, laundry, etc.?)?
Highly dissatisfied
1
2
3
4
5
Highly satisfied
Comment
7.
What items/services you felt were lacking or that you wished were available? Was there anything else you felt could have been included in your welcome bag?
8.
What suggestions/improvements do you have for the Family Room facility and for our services?
9.
What did you appreciate/enjoy the most about our services?
10.
We love sharing stories from past families with our supporters. Not only do family stories like yours give a face to what we do, but they give other families hope and support so they don't feel so alone. We would love the opportunity to share your story. If you're interested in sharing your experience, please share it below:
11.
Is there anything else you'd like to share about the impact RMHC had on you and your family?
12.
If anyone has been especially helpful during your stay, please let us know:
