Exit this survey Hospital Performance Evaluation Template Question Title * 1. How easy was it to talk to the staff at this hospital about your medical condition(s)? Extremely easy Very easy Moderately easy Slightly easy Not at all easy Question Title * 2. How well did the staff at this hospital keep you informed about your treatment options? Extremely well Very well Moderately well Slightly well Not at all well Question Title * 3. How often did you receive conflicting information from the staff at this hospital? Extremely often Very often Moderately often Slightly often Not at all often Question Title * 4. How responsive was the staff at this hospital to your questions? Extremely responsive Very responsive Moderately responsive Slightly responsive Not at all responsive Question Title * 5. How considerate was the staff at this hospital? Extremely considerate Very considerate Moderately considerate Slightly considerate Not at all considerate Question Title * 6. How professional was the staff at this hospital? Extremely professional Very professional Moderately professional Slightly professional Not at all professional Question Title * 7. How knowledgeable was the staff at this hospital? Extremely knowledgeable Very knowledgeable Moderately knowledgeable Slightly knowledgeable Not at all knowledgeable Question Title * 8. How clean were the areas in which you were treated at this hospital? Extremely clean Very clean Moderately clean Slightly clean Not at all clean Question Title * 9. How clean was your room or sleeping space at this hospital? Extremely clean Very clean Moderately clean Slightly clean Not at all clean Question Title * 10. How noisy was your room or sleeping space at this hospital? Extremely noisy Very noisy Moderately noisy Slightly noisy Not at all noisy Question Title * 11. How respectful of your religious commitments was the staff at this hospital? Extremely respectful Very respectful Moderately respectful Slightly respectful Not at all respectful Question Title * 12. How well did the meals served at this hospital meet your dietary needs? Extremely well Very well Moderately well Slightly well Not at all well Question Title * 13. Overall, were you satisfied with the care you received at this hospital, neither satisfied nor dissatisfied with it, or dissatisfied with it? Extremely satisfied Moderately satisfied Slightly satisfied Neither satisfied nor dissatisfied Slightly dissatisfied Moderately dissatisfied Extremely dissatisfied Done