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Kimball Health Services

Survey - Emergency Services

Kimball Health Services wants to provide the best possible service to you, our patient. Please help us better serve you by completing the survey. Feel free to express your opinions frankly.
After each statement, please mark the letter which reflects your satisfaction/opinion:
Excellent=E, Good=G, Fair=F, Poor=P
  Date
Date of service:
* Nursing
I was met with courtesy and respect by the nursing staff.
E     G     F     P    
* Providers
I was treated with courtesy and respect by the medical provider/physician.
E     G     F     P    
* Privacy
My privacy was respected.
E     G     F     P    
Time
I felt the amount of time I spent was appropriate...
* Time
In the Emergency Room.
E     G     F     P    
* Time
To see a Nurse.
E     G     F     P    
* Time
To see a Medical Provider.
E     G     F     P    
* Time
To receive treatment.
E     G     F     P    
* Explanations
I received adequate explanations of procedures and tests by the nurse/provider.
E     G     F     P    
* Pain
I was satisfied with how my pain was controlled while in the Emergency Room.
E     G     F     P    
* Discharge
Adequate discharge instructions were provided.
E     G     F     P    
  Med Assistance (if applicable)
If needed, assistance was provided to obtain medications.
E     G     F     P    
* Care
The overall quality of care I received was.
E     G     F     P    
* Provider
If you recall, please indicate the name of the medical provider/physician who saw you.
* Lab (if applicable)
Waiting time in the lab area.
E     G     F     P    
* Courtesy
I was met with courtesy and respect by the lab personnel.
E     G     F     P    
* Radiology (if applicable)
Waiting time in the radiology area
E     G     F     P    
* Courtesy
I was met with courtesy and respect by the radiology personnel
E     G     F     P    
* Ambulance Services (if applicable)
I arrived at the hospital by ambulance
yes     no    
* Transferred
I was transferred to another facility by ambulance.
yes     no    
* Questions
Overall, the staff adequately answered my questions.
E     G     F     P    
* Skilled
Overall, I believe the staff were properly skilled.
E     G     F     P    
* Name
The staff called me by name.
E     G     F     P    
* Professional
Overall, the staff were professional and courteous.
E     G     F     P    
* Expectations
My needs and expectations were met.
E     G     F     P    
  Comments
List any comments you might have:
* Recommend
Would you recommend our facility to others?
yes     no    
* Pleasing
Was there any particular thing or person who made your visit especially pleasing?