Recently you visited the Deaconess ER, and we'd like to know what you thought of your experience. Your opinion is important to us. Please take a moment to circle or check your answers. Let us know how we're doing! Every month we will be drawing names from the returned satisfaction surveys for a gift card to a local retailer. Fill this out and you might be a winner!

1. Were you seen within twenty minutes?
Yes
No
2. If not, were you given a Graeter's gift card?
Yes
No
3. Was the registration clerk courteous and helpful?
Yes
No
4. Was the physician courteous and caring?
Yes
No
5. Was the nursing staff courteous and caring?
Yes
No
6. Were diagnosis, tests and treatment plans explained to you?
Yes
No
7. How did you/your loved one arrive at the hospital (please check)
Family/Friend
Brought myself
Ambulance
Other
8. How did you learn about the Deaconess ER?
Billboards
TV News
Family/Friend
Mailer
Radio (please name)
Other
9. Was it easy to find the ER?
Yes
No
10. Would you recommend the Deaconess ER to friends or family?
Yes
No
Other comments
You may use my comments and name on the Deaconess website.
Yes
No
Email
First Name
Last Name
Address
City
State
Zip
Phone
 
Deaconess Hospital