Cosmetic Surgery Clinic: Patients Service Centre: Post-operative Quality Survey

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Post-operative Quality Survey

Dear Patient,

Could we please ask you to take a few moments to complete the following survey and return it to us to ensure we provide you and our other patients with the highest quality care possible?

Just fill in the questionnaire, and send it to us online by clicking the submit button. Or if you prefer, print it out (get a printer friendly version by using the link above) and fax or post it to us.

20 Manning Road Double Bay N.S.W. 2028 Telephone: (02) 9362 7400 Facsimile: (02) 9328 6036

Patient name (optional):
Address:
Date of surgery:

1. How did you find your visit to the Double Bay Surgery overall?

2. Were you made to feel welcome on admission?	Yes No
3. Were you admitted in a timely fashion?	Yes No
4. Was your privacy maintained at all times?	Yes No
5. Was the temperature of the facility comfortable?	Yes No
6. Were you offered refreshments?	Yes No
If yes, were these satisfactory?	Yes No
7. Was your pain controlled?	Yes No
8. Did you suffer any vomiting in the first 24 hours post-operatively?	Yes No
If yes, were you given medication to treat this?	Yes No
9. Did you make use of the after-hours on-call nursing service?	Yes No
If yes, were you satisfied with the standard of care given?	Yes No
10. Did you make use of the after-hours on-call nursing service?	Yes No
If yes, were you satisfied with the standard of care given?	Yes No
11. Would you recommend the facility to other people?	Yes No
12. Would you use the facility again in the future?	Yes No

Do you have any other suggestions or comments?

Thank you for your time. We look forward to improving our service based on your constructive input.

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The Cosmetic and Restorative Surgery Clinic and the Double Bay Day Surgery
20 Manning Road, Double Bay 2028, Australia
tel:+61 (2) 9362 7400 fax:+61 (2) 9328 6036