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1 2 3 4 5 N 1. Reception and registration process 2. Care provided by the nursing staff before your procedure 3. Care provided by the nursing staff During your procedure 4. Care provided by the nursing staff after your procedure 5. Protection of your privacy 6. Cleanliness and appearance of the facility 7. Your overall confidence in the care provided to you by the staff 8. Your overall experience at the facility   Y N 11. Would you recommend the facility to family members or friends? 12. Did you receive discharge instructions? 13. Were the instructions clear? What did you like best about your experience at the facility? What did you like least about your experience at the facility? Any Other Comments? Can GRSC contact you directly on the feedback you have provided? Yes No Please enter your First Name Please enter your Last Name Please enter your Email Address Please enter your Telephone Number
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