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Senior Life Solutions Patient Satisfaction Survey

To help us improve our services, please complete this brief patient survey after discharge. Participation is voluntary and responses are anonymous.
When you submit this form, it will not automatically collect your details like name and email address unless you provide it yourself.
1.Please enter the STATE where the Senior Life Solutions program was located.(Required.)
2.Please enter the CITY where the Senior Life Solutions program was located.(Required.)
3.PLEASE RATE THE FOLLOWING QUESTIONS USING THIS SCALE:(Required.)
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
I feel this program addressed my needs.
I feel better now than when I was admitted.
Program staff treated me with dignity and respect.
Staff listened to my needs and responded timely.
The psychiatrist treated me well and listened.
I had input into my treatment goals.
The group therapy topics were helpful.
The nursing / OPC groups were helpful.
I was provided information on my medication.
I would recommend this program to others.
4.What did you like MOST about your treatment?
5.What did you like LEAST about your treatment?
6.Please share any additional COMMENTS or SUGGESTIONS for improving our program.
7.By completing this survey, I give Senior Life Solutions permission to use my anonymous comments in marketing materials. (If you would like to opt out, please choose no below.)(Required.)