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PATIENT SATISFACTION SURVEY
Dear Northern Inyo Hospital Patient: We hope your experience was
a positive one. Please complete the following survey by circling one of the
following: (P=Poor; F=Fair; A=Average; G=Good;
E=Excellent).
| Day of Week Seen:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday |
| Dept Seen In:
OutPt
ER
In Patient
RHC
Radiology
Lab |
| Overall quality of care and services |
P |
F |
A |
G |
E |
| Respect for my privacy |
P |
F |
A |
G |
E |
| Admitting Process |
P |
F |
A |
G |
E |
| Nursing Care |
P |
F |
A |
G |
E |
| Physician Care |
P |
F |
A |
G |
E |
| X-ray Services |
P |
F |
A |
G |
E |
| Laboratory Services |
P |
F |
A |
G |
E |
| Staff listened and answered my questions |
P |
F |
A |
G |
E |
| Registration waiting time ______ minutes. Experience
was: |
P |
F |
A |
G |
E |
| Procedure waiting time ______ minutes. Experience was: |
P |
F |
A |
G |
E |
| Would you recommend this hospital to a friend? |
No |
Probably not |
Not Sure |
Maybe |
Yes |
Print and
Mail to: Attn: Administration
Office
Or e-mail comments to:
NIH.Administration@nih.org
Northern Inyo Hospital
150 Pioneer Lane
Bishop, CA 93514
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