Patient Experience Survey Form 1. Personal Details 2. Pre-Operative Details 3. After-Care Team 4. Communication Experience 5. Surgical Experience 6. Overall Experience 1. Personal Details 2. Pre-Operative Details 3. After-Care Team 4. Communication Experience 5. Surgical Experience 6. Overall Experience Thank you for choosing our practice for your care. To help us improve and provide the best possible experience, we would appreciate your feedback about your journey before, during, and after surgery. Please Note: You may skip this Personal Details section for anonymous submission and click Next Step. First Name Last Name Email Address Phone Number Next Step > Consultant Team How would you rate the information provided during your pre-operative consultations? ExcellentGoodFairPoor Were your questions answered adequately by the pre-operative team? Yes, completelySomewhatNot reallyNot at all Was the scheduling process smooth and convenient? YesNo < Previous Step Next Step > Nursing Team How would you rate the care and professionalism of the nursing team during your recovery? ExcellentGoodFairPoor How would you rate the care received from the physician assistants during the recovery? ExcellentGoodFairPoor Surgical Technicians How would you describe your interactions with any surgical technicians? ExcellentGoodFairPoor Did the post-operative instructions provided by the team meet your needs and address all your questions? Yes, very clearSomewhat clearNot clear at all < Previous Step Next Step > General Communication How easy was it to reach someone on the phone for assistance or questions? Very easySomewhat easyDifficultVery difficult Were your phone or email inquiries handled promptly and professionally? Yes, alwaysSometimesRarelyNever < Previous Step Next Step > Surgeon Rating How would you rate your experience with your surgeon? ExcellentGoodFairPoor Did your surgeon communicate effectively, including setting realistic expectations? Yes, very wellSomewhat wellNot very wellNot at all Are you satisfied with the outcome of your surgery so far? Very satisfiedSomewhat satisfiedNeutralDissatisfied < Previous Step Next Step > Overall Experience How likely are you to recommend our practice to others? Very likelyLikelyNeutralUnlikely Is there anything we could have done better during your care? Please share any additional thoughts or suggestions. * < Previous Step Submit