Hospital Services - In-Patient example

This is an example Hospital Services - In-Patient survey. This survey includes questions like:

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Registration

Please tell us how satisfied or dissatisfied you were with each of the following.
1) How satisfied were you with the ease of registration?
  • Very Satisfied
  • Somewhat Satisfied
  • Undecided
  • Somewhat Dissatisfied
  • Very Dissatisfied
2) How satisfied were you with the explanations you received regarding billing procedures?
  • Very Satisfied
  • Somewhat Satisfied
  • Undecided
  • Somewhat Dissatisfied
  • Very Dissatisfied
Please tell us how much you agree or disagree with each of the following statements.
3) The registration representative was friendly and respectful.
4) The registration representative fully answered all my questions.

Nursing Staff

Please tell us how satisfied or dissatisfied you were with each of the following.
5) How satisfied were you with the friendliness of the nursing staff?
  • Very Satisfied
  • Somewhat Satisfied
  • Undecided
  • Somewhat Dissatisfied
  • Very Dissatisfied
6) How satisfied were you with the professionalism of the nursing staff?
  • Very Satisfied
  • Somewhat Satisfied
  • Undecided
  • Somewhat Dissatisfied
  • Very Dissatisfied
7) How satisfied were you with the frequency with which the nurses checked on you while you were an in-patient in this hospital?
  • Very Satisfied
  • Somewhat Satisfied
  • Undecided
  • Somewhat Dissatisfied
  • Very Dissatisfied
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