Boston Children's Hospital Patient Satisfaction Survey

Date

• Select date

  Date

Floor and Unit

• Select 6 Northeast 6 North BMT 6 South CATH Lab 6 Mandell 7 South Medical ICU 7 West 7 North NICU 8 South Cardiac ICU 8 East Cardiac 9 East 9 South 9 Mandell 10 NW 10 East 10 Mandell 11 South ICU 11 South MICU

  • 6 Northeast
  • 6 North BMT
  • 6 South CATH Lab
  • 6 Mandell
  • 7 South Medical ICU
  • 7 West
  • 7 North NICU
  • 8 South Cardiac ICU
  • 8 East Cardiac
  • 9 East
  • 9 South
  • 9 Mandell
  • 10 NW
  • 10 East
  • 10 Mandell
  • 11 South ICU
  • 11 South MICU

Room Number

Prepared by

• Nichole Collens

  Michael Levine

Survey Questions

• Would you have 5 minutes to discuss your experience with a couple of topics? Please think of this admission only for this survey. Just as you are here to get better, we are conducting this survey so that we too can get better!

Food Services

During this hospital stay, how would you rate the overall quality of the meals your child was served.

• Select Excellent Good Average Fair Poor Unable or Have not Eaten

  • Excellent
  • Good
  • Average
  • Fair
  • Poor
  • Unable or Have not Eaten

Please rate the overall temperature of the food your child received on this hospital stay.

• Select Excellent Good Average Fair Poor Unable or Have not Eaten

  • Excellent
  • Good
  • Average
  • Fair
  • Poor
  • Unable or Have not Eaten

Environmental Services

Please rate the overall cleanliness of your room during this hospital stay.

• Excellent

  Good

  Average

  Fair

  Poor

Bearing in mind that you and your child may be in and out of the room throughout the day for tests, procedures, etc... Based on the cleanliness of the room and your private bathroom, how often has your child's room and bathroom been cleaned?

• Always

  Usually

  Sometimes

  Rarely

  Never

Service Response Center

If you contacted the Service Response Center to order a meal, please rate the overall courtesy of the call center representative.

• Select Excellent Good Average Fair Poor Unable or Have not Eaten

  • Excellent
  • Good
  • Average
  • Fair
  • Poor
  • Unable or Have not Eaten

Please share any other comments you have about your child's stay.

Thank You!!