OISC Questionnaire

Thank you in advance for completing this survey. Please complete the questions and feel free to add comments, when complete click the submit button.

Patient Survey

Discharge patient survey
  • Date Format: MM slash DD slash YYYY
  • Registration

  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Facility

  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Before your Surgery

  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • After Your Surgery

  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent
  • Needs ImprovementBelow AverageFairVery GoodExcellent