Laboratory Department Excelsior Springs Hospital

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* 1. What was your overall impression of the laboratory department?

Excellent

Very Good

Good

Fair

Poor

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* 2. How likely are you to recommend our laboratory department to your family and friends?

Very likely

Likely

Neither likely nor unlikely

Unlikely

Very unlikely

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* 3. How long did you wait for assistance?

Less than 5 minutes

5-10 minutes

10-15 minutes

15 minutes or more

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* 4. The staff was compassionate and caring.

Strongly Agree

Agree

Disagree

Strongly disagree

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* 5. Did staff explain things in a way you could understand?

Yes

N/A

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* 6. How often did the staff respect and protect your privacy?

Always

Usually

Sometimes

Never

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* 7. Did the staff verify your name and date of birth prior to your procedure today?

Yes

Unsure

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* 8. Please rate the service you received from the Admitting/Registration department.

Excellent

Very Good

Good

Fair

Poor

N/A

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* 9. Did you have any concerns or questions that were not addressed to your satisfaction?

Yes

Other comments

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* 10. Date of visit

Date

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* 11. Contact Information (Optional)

Name

Email Address

Phone Number

Thank you for taking the time to fill out our survey so that we may improve our services to our patients. Your suggestions are very important to us.

If you have additional information or concerns please feel free to contact:

Director of the Laboratory Department
816-629-2767