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* 1. Who is completing this survey?

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* 2. Your Day Surgery visit was to which area?

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* 3. Did the health professionals treating and examining you introduce themselves?

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* 4. Before your procedure, did a health professional explain what would happen to you, in a way you could understand?

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* 5. Before your procedure, did your doctor or anyone from the hospital give you easy to understand instructions about getting ready for your procedure?

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* 6. If you had to wait, were you told why?

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* 7. If you had any worries or fears about your condition or treatment, did a surgeon talk with you about them?

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* 8. If you had questions to ask the anaesthesiologist, did you get answers that you could understand?

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* 9. How much information about your condition or treatment was given to your family, caregiver or someone close to you?

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* 10. How often, during your most recent day surgery experience, were you involved as much as you wanted to be in decisions about your care and treatment?

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* 11. Before you left the hospital, were you told what would happen next (for example, did you need another appointment, did you need to see your family doctor)?

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* 12. Did you receive information about what symptoms or health problems regarding your illness or procedure to watch for at home?

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* 13. Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital?

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* 14. Overall, did you feel you were treated with respect and dignity while you were at the hospital?

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* 15. Thinking about your experience related to this day surgery visit, to what extent did you experience smooth transitions between the hospital and other locations or health professionals?

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* 16. Overall...(Please pick a number)

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* 17. What else would you like to share about your visit to Day Surgery?

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* 18. Is there a staff member or group that you would like to recognize for providing exceptional care or service?

If you have any immediate questions or concerns regarding your experience with us, please contact our Patient Relations Office using the contact information below.

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