Name (optional)Email (optional) Date MM slash DD slash YYYY Please Rate Your Level of CareI received prompt attention to my needs throughout the visit.(Required) Excellent Very Good Good Fair Poor The pre-operative instructions I was given were clear and understandable.(Required) Excellent Very Good Good Fair Poor My questions were answered in a clear, concise and understandable manner.(Required) Excellent Very Good Good Fair Poor I was comfortable sharing my concerns or questions with the staff and physicians.(Required) Excellent Very Good Good Fair Poor Every effort was made to keep me as comfortable and pain-free as possible.(Required) Excellent Very Good Good Fair Poor Staff were considerate of my thoughts and feelings.(Required) Excellent Very Good Good Fair Poor The care I received from the Nurses were..(Required) Excellent Very Good Good Fair Poor The care I received from the Anesthetist was…(Required) Excellent Very Good Good Fair Poor The care I received from the Surgeon was…(Required) Excellent Very Good Good Fair Poor I received adequate instructions on how I should care for myself after discharge.(Required) Excellent Very Good Good Fair Poor Any Comments You Would Like To Share With Us:Following Your Surgery…Did you require admission to a hospital in the 24 hours immediately following your surgery?(Required) Yes No Did you require unplanned medical attention related to the surgery, any adverse effects (pain management, symptoms of infection, etc.)?(Required) Yes No If you have any comments or questions, please contact Brittany Smith, Alexi Rositch Directors of Surgical Services. Phone: (250) 868-9799, Fax: (250) 868-9734, Email: [email protected]CAPTCHA