Satisfaction Survey

Thank you for choosing Lake Ridge Ambulatory Surgery Center for your procedure. We hope that your experience was positive and that you are well on your way to recovery. Your comments and suggestions are important to us. Please assist us in continuing to provide the very best care possible by completing the short survey below.

Patient's Name:
Optional
Physician's Name:
Date of procedure:
If you don't know the exact date, please estimate.
Date Format: MM slash DD slash YYYY
Please indicate your overall impression of your surgical experience at Lake Ridge Ambulatory Surgery Center:
Excellent Above Average Average Below Average Poor
Would you recommend Lake Ridge Ambulatory Surgery Center to family & friends?
Yes No Not Sure
How did you hear about Lake Ridge Ambulatory Surgery Center?
- Friend
- Family Member
- Advertisement
- Physician/Surgeon
- Other
Pre-Admission phone call was clear and helpful:
Excellent Above Average Average Below Average Poor N/A
Directions to the surgery center were accurate and easy to follow:
Excellent Above Average Average Below Average Poor N/A
Billing and insurance information was clear:
Excellent Above Average Average Below Average Poor
The reception staff greeted me promptly, in a professional and courteous manner:
Excellent Above Average Average Below Average Poor
The nursing staff was warm and friendly:
Excellent Above Average Average Below Average Poor
I received personalized care with compassion, respect and concern for my privacy and my physical comfort:
Excellent Above Average Average Below Average Poor
The surgeon demonstrated courtesy and concern:
Excellent Above Average Average Below Average Poor
The anesthesiologist/nurse anesthetist demonstrated courtesy and concern:
Excellent Above Average Average Below Average Poor N/A
Prior to my admission date, I was made aware that I needed a responsible party to stay with me for 24 hours:
Excellent Above Average Average Below Average Poor N/A
At the time of discharge, I was well informed about what to do in the next 24 hours:
Excellent Above Average Average Below Average Poor
The written information provided was easy to understand:
Excellent Above Average Average Below Average Poor
The telephone follow-up after the procedure was helpful and informative:
Excellent Above Average Average Below Average Poor N/A
The care I received was timely and I did not experience any lengthy delays:
Excellent Above Average Average Below Average Poor
If your procedure was delayed, how well were you kept informed of the delay:
Excellent Above Average Average Below Average Poor N/A
I was cared for in a safe and efficient manner:
Excellent Above Average Average Below Average Poor
While I was in the facility, I saw the staff members and physicians wash their hands with soap and water or alcohol hand cleanser:
Excellent Above Average Average Below Average Poor
Please feel free to offer any comments or suggestions in areas where we could improve or areas where we excelled: