TDMH Patient Family Experience Survey Question Title * 1. What department of the hospital did you visit? Question Title * 2. In what month were you at the hospital? January February March April May June July August September October November December Question Title * 3. Please rate your overall experience Excellent Good Poor Question Title * 4. If you had to come back to hospital, would you return to our hospital? Yes No Question Title * 5. On a scale of 1 to 10, how willing would you be to recommend this hospital to your family and friends? 1 2 3 4 5 6 7 8 9 10 Question Title * 6. On a scale of 1 to 10 how would you rate the cleanliness of this facility? 1 2 3 4 5 6 7 8 9 10 Question Title * 7. On a scale of 1 to 10, how helpful and respectful did you find the staff and volunteers of this hospital? 1 2 3 4 5 6 7 8 9 10 Question Title * 8. On a scale of 1 to 10, how well marked and easily identified was the area of the hospital you needed to visit? 1 2 3 4 5 6 7 8 9 10 Question Title * 9. On a scale of 1 to 10, how helpful were staff members and volunteers in addressing your needs? 1 2 3 4 5 6 7 8 9 10 Question Title * 10. On a scale of 1 to 10, how well did hospital staff include you, a family member, or a caregiver in discussions about your care? 1 2 3 4 5 6 7 8 9 10 Question Title * 11. Did you receive the information you needed for discharge? Yes No Question Title * 12. How effective were the staff in providing communication and updates about wait times during your stay? 1 2 3 4 5 6 7 8 9 10 Question Title * 13. Do you have any suggestions that could improve your overall experience? Question Title * 14. Is there a staff member or group that you would like to recognize for providing exceptional care or service? Question Title * 15. If you would like to be contacted for further follow up, please provide your name and contact information. Done