OISC Patient Survey

Home / OISC Patient Survey

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

Procedure Date*
Date Format: MM slash DD slash YYYY
Patient's Sex*
- Male
- Female
Patient's Age*
Registration
Adequately informed patients of rights / responsibilities
Needs Improvement Below Average Fair Very Good Excellent
Adequately informed patients of rights / responsibilities
Needs Improvement Below Average Fair Very Good Excellent
Comments Regarding Registration Process (describe positive or negative experiences)
Facility
Comfort of Facility
Needs Improvement Below Average Fair Very Good Excellent
Attractiveness of Surgery Center
Needs Improvement Below Average Fair Very Good Excellent
Cleanliness of Surgery Center
Needs Improvement Below Average Fair Very Good Excellent
Comments Regarding the Facility (describe positive or negative experiences)
Before your Surgery
Waiting time prior to your surgery
Needs Improvement Below Average Fair Very Good Excellent
Courtesy of surgeon
Needs Improvement Below Average Fair Very Good Excellent
Explanation of surgeon regarding your surgery
Needs Improvement Below Average Fair Very Good Excellent
Explanation of anesthesiologist regarding your anesthetic
Needs Improvement Below Average Fair Very Good Excellent
Explanation and helpfulness of preoperative nurse(s)
Needs Improvement Below Average Fair Very Good Excellent
Comments Regarding the Pre-operative Experience (describe positive or negative experiences)
After Your Surgery
Nurses concern for comfort after procedure
Needs Improvement Below Average Fair Very Good Excellent
Management of pain during recovery period
Needs Improvement Below Average Fair Very Good Excellent
Information surgeon provided to family after surgery
Needs Improvement Below Average Fair Very Good Excellent
Courtesy of nurses towards family
Needs Improvement Below Average Fair Very Good Excellent
Instructions nurses gave you / your family after surgery
Needs Improvement Below Average Fair Very Good Excellent
Your confidence in the skills of surgeon / anesthesia team / nursing / staff
Needs Improvement Below Average Fair Very Good Excellent
Comments Regarding the Post-operative Experience (describe positive or negative experiences)
General Comments
Would You Recommend Our Facility?
- Yes
- No

OISC Patient Survey

OISC Questionnaire

Patient Survey

Registration

Facility

Before your Surgery

After Your Surgery