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Thank you for agreeing to complete our Family Exit Survey. Your answers are completely confidential and will be used to enhance our services to families

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* 1. If you are interested in receiving information about The Ronald McDonald House of Delaware, please enter your email below

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* 2. Within the past month, have you stayed at The Ronald McDonald House of Delaware prior to this time?

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* 3. How would your family have been impacted if the Ronald McDonald House did not exist?

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* 4. What was your room number?

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* 5. Was everything in your room in working order?

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* 6. How long was your stay at The Ronald McDonald House?

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* 8. Did your family use any of the following services offered by the House?

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* 9. Environment/ Atmosphere 
Please tell us how you would rate your experience at the Ronald McDonald House of Delaware in each of the areas below.

  1- Very Poor 2- Poor 3- Average 4- Good 5- Very Good N/A
The cleanliness of your room and bathroom
The comfort of your room and bathroom
The noise level in and around your room
The kitchen and the equipment (i.e. pots and pans, pantry?) you needed to prepare your own meals
Availability of meals (provided by others)
Availability of transportation
Availability of activities for you and your family
Hospitality (helpfulness & friendliness) of staff and volunteers 
 The safety of the area in and around the Ronald McDonald House
Your overall experience at the Ronald McDonald House 

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* 10. Impact on My Family:
For each area below, please check the box that best describes how your stay at the Ronald McDonald House affected your family.

  Strongly Disagree Disagree Neither Agree Nor Disagree Agree Strongly Agree
Because of the Ronald McDonald House, I was better able to rest and maintain my physical well being while my child was receiving medical care.
While staying at the Ronald McDonald House, I felt emotionally supported from other families staff and volunteers.
My ability to stay close by, improved my child's experience at the hospital.
My ability to stay close by improved my child's recovery at the hospital.
I was better able to follow my doctor's recommendations because we were able to stay close to the hospital and my child.
The Ronald McDonald House helped my family stay together during a very difficult time. 

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* 11. Any comments or ideas for how we can improve on any of these services: Handicap Accessibility, Family Services, Family Activities, Transportation or Other?

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* 12. Would you stay at the House again in the future if needed?

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