Patient SurveyHospital Survey: How are we doing?Your opinion is valuable to us, Please give us your feedback about your experience while at the hospital. Please take a few minutes to fill out this survey on the timeliness and quality of the service you received today. Rangely District Hospital welcomes your feedback and your answers will be kept confidential. Thank you for your participation.GENERAL PATIENT INFORMATIONIn general, what is the quality of your health? (required)OutstandingGoodSome Chronic IssuesPoorHow would you rate our concern for your privacy? (required)OutstandingGoodAdequateNeeds ImprovementPoorN/AHow often have you visited RDH within the past year? (required)First Visit2-5 VisitsMore Than 6If you were seeking a referral to a specialist, was your request handled in a timely manner? (required)YesNoN/AWhich department did you visit? (required)LabRadiologyCardio/PulmonaryERP/TClinicN/ATHE NURSING STAFFHow would you rate the competence of the nurse who helped you? (required)OutstandingGoodAdequateNeeds ImprovementPoorN/AHow would you characterize the concern shown to you by the nurse? (required)OutstandingGoodAdequateNeeds ImprovementPoorDid the nurse respond to you within a reasonable period of time? (required)YesNoTHE DOCTORSWere you able to see the doctor of your choice? (required)YesNoN/AWere you able to see the doctor of your choice? (required)YesNoN/AMark the boxes that characterize the demeanor of your doctor (required)AttentiveConcernedFriendlyDistractedRushedInconsiderateHow would you rate the competence of your doctor? (required)OutstandingGoodAdequateNeeds ImprovementPoorN/ADid you feel that your doctor's exam was thorough? (required)YesNoN/APlease rate the clarity of your doctor's explanation of your condition and treatment options? (required)OutstandingGoodAdequateNeeds ImprovementPoorN/AHow well did your doctor include you in your healthcare decisions? (required)OutstandingGoodAdequateNeeds ImprovementPoorN/AWere your questions answered to your satisfaction? (required)YesNoN/ACLINICIf you needed an appointment, did you have to wait longer than expected? (required)YesNoHow easy was it to make an appointment by telephone? (required)Very EasyModerately EasyVery DifficultHow long did you wait to speak to a scheduling staff member? (required)0 to 2minutes3 to 5minutes5 to 7minutesLongerWas the person who scheduled your appointment courteous and helpful? (required)Very CourteousModerately CourteousRudeHow would you rate the courtesy of the staff at the reseption desk? (required)Very CourteousModerately CourteousRudeHow long did you wait in the reception area beyond your appointment time? (required)0 to 5minutes5 to 20minutes20 to 40minutesLongerHow long did you wait in the exam room before you saw your physician? (required)0 to 5minutes5 to 20minutes20 to 40mintuesLongerTHE LAB STAFFHow would you rate the professionalism and competence of the lab tech who took your blood? (required)OutstandingGoodAdequateNeeds ImprovementPoorHow long did you have to wait to speak to a lab tech? (required)0-2minutes3-5minutes5-7minutesLongerBUSINESS OFFICEHow would you rate your level of satisfaction with our business office staff? (required)Very SatisfiedSatisfiedDissatisfiedVery DissatisfiedHow would you rate the helpfulness of the business office staff? (required)Very HelpfulHelpfulNot HelpfulIndifferentIf you had an issue with your bill, did you feel that you received the necessary help to resolve your issue? (required)YesNoHow would you rate your overall experience in dealing with the hospital staff and services? (required)Very satisfiedSatisfiedAdequateNeeds ImprovementPoorADDITIONAL FEEDBACKPlease list any areas in which our services could be improved. (required)Please share any additional comments you may have. (required)PERSONAL INFORMATION Providing the following information is optional.First Name (required)Last Name (required)Address (required)City (required)Telephone (required)Would you like some one to contact you? (required)YesNoThere was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.