Patient Survey

Our goal is to provide you with the best food service possible. We are constantly striving to improve our service and value your input/comments. Your cooperation in completing this survey will be most appreciated.

If you are human, leave this field blank.

Name

First

Last

Room Number

Date

The Culinary Experience - 5 = Storngly Agree 4 = Somewhat Agree 3 = Neutral 2 = Somewhat Disagree 1= Strongly Disagree

The hot food was served hot.

The cold food was served cold.

The appearance of the food was appealing.

There was a variety of food options.

The flavors of the food were satisfying.

The meals were served in a timely manner.

The kitchen staff was accommodating to your dietary needs.

You are satisfied with the culinary experience.

Did you receive food you like?

Yes

Did you receive the alternate if preferred?

Yes

Were you offered snacks?

Yes

Comments

What could we do to make the food service better? *