Food and Nutrition Survey

Please take a few minutes to fill out this brief survey regarding our dining service.

Thank you for choosing NYP.

Question Title

* 1. Select Location

Question Title

* 2. What diet are you currently on? (select all that apply). Your nurse or dining host can share this information with you.

Regular

Cardiac/Low sodium/Low Fat

Carbohydrate controlled

Renal/Low Potassium

Gluten Free

Puree

Dysphagia diet

Kosher

Vegetarian

Vegan

Other

Other (please specify)

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* 3. How would you rate the food quality?

Excellent

Very good

Good

Fair

Poor

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* 4. How would you rate the temperature of the food?

Excellent

Very good

Good

Fair

Poor

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* 5. Please rate the courtesy of the person who served your food.

Excellent

Very Good

Good

Fair

Poor

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* 6. According to your diet, are you satisfied with the variety of choices on the menu?

Yes

(If No, please tell us what you would like to see added to the menu)

Food and Nutrition Survey

Question Title

* 1. Select Location

Question Title

* 2. What diet are you currently on? (select all that apply). Your nurse or dining host can share this information with you.

Question Title

* 3. How would you rate the food quality?

Question Title

* 4. How would you rate the temperature of the food?

Question Title

* 5. Please rate the courtesy of the person who served your food.

Question Title

* 6. According to your diet, are you satisfied with the variety of choices on the menu?

Question Title

* 7. Is there anything else you’d like to share about the food or dining service?