How Did We Do? Patient Satisfaction SurveyΔPatient Satisfaction SurveyFirst Name (Optional)Last Name (Optional)The home infusion/feeding pump was clean when it was delivered. Yes No I did not use a home infusion/feeding pump.The home infusion/feeding pump worked properly. Yes No I did not use a home infusion/feeding pump.The medications, equipment, and supplies were delivered on time. Yes NoI knew who to call if I needed help with my home infusion or tube feeding therapy. Yes NoThe response I received to phone calls for help on weekends or during evening hours met my needs. Always Very Often Sometimes Rarely Never I did not need to call for help on the weekends or during evening hours.The home infusion nurse or pharmacist informed me of possible side effects/complications of the home infusion medications/tube feeding solutions. Yes NoI understood the explanation of my financial responsibilities for home infusions/tube feeding therapy. Yes NoHow often was the delivery staff helpful? Always Very Often Sometimes Rarely Never Not applicableHow often was the billing staff helpful? Always Very Often Sometimes Rarely Never Not applicableHow helpful was the pharmacy staff? Always Very often Sometimes Rarely Never Not applicableHow helpful was the nursing staff? Always Very often Sometimes Rarely Never Not applicableHow courteous was the delivery staff? Always Very often Sometimes Rarely Never Not applicableHow courteous was the billing staff? Always Very often Sometimes Rarely Never Not applicableHow courteous was the pharmacy staff? Always Very often Sometimes Rarely Never Not applicableHow courteous was the nursing staff? Always Very often Sometimes Rarely Never Not applicableWritten/Website educational materials provided were adequate. Yes NoI understood the instructions provided for how to wash my hands when handling my infusion/feeding. Yes No Not applicableI understood the instructions provided for how to administer home infusion medications/tube feeding. Yes No Not applicableI understood the instructions provided for how to care for the IV catheter/feeding tube. Yes No Not applicableI understood the instructions for how to store the home infusion medication/tube feeding solution. Yes No Not applicableI understood the instructions for how to use the home infusion pump/tube feeding pump. Yes No Not applicableI was satisfied with the overall quality of the services provided. Yes NoI would recommend Coastal Infusion Services to my family and friends. Yes NoHow can we improve our products/services?Submit Form Share this:TwitterFacebookLike this:Like Loading...
