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Shmuel Harofeh Hospital Affiliated with the Sackler School of Medicine, Tel Aviv University
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State of Israel
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Feedbak On The Patient’s Experience During Hospitalization


Dear patient / family,

Shmuel Harofeh Geriatric Hospital is a leading hospital in the field of geriatric care. We place importance on the patient’s wellbeing, quality of care, and services provided.

We would be pleased to receive your impressions and reactions towards helping us to continue improving our services.

The attached questionnaire relates to your most recent hospitalization or that of your family member. The questionnaire is anonymous. Please circle the appropriate response, where 1 is not good and 5 is excellent. Please try to answer all the questions.

Our thanks in advance for your cooperation.

 


 

All fields marked with an asterisk (*) are required
 
Questions concerning the medical staff (1 not good, 5 excellent)
Questions concerning the nursing staff (1 not good, 5 excellent)
Questions concerning assistance staff (1 not good, 5 excellent)
Patient empowerment in current hospitalization (1 not good, 5 excellent)
Attitude and care by other staff members (1 not good, 5 excellent)
Patient wellbeing (1 not good, 5 excellent)
Hospitalization condition (1 not good, 5 excellent)
Contribute and influence
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