Inpatient Survey

Mark the rating that best represents your experience for each of the questions below.  If you had no experience with a particular item, mark (N/A) not applicable.  Please comment on any positive or negative experiences you may have had.  We appreciate your opinions and thank you for your time.


Please have the paper survey that was sent in the mail  nearby, as you will need the patient number and code from the bottom.



Patient Number



Unit Care of Code

INpatient SurveyClickHere