Name
Email
Phone
Please rate the following (scale of 1 to 5, with 5 being best):
The pre-admission phone call was informative and helpful.
5    4    3    2    1    NA   
The admitting process was welcoming and efficient.
5    4    3    2    1    NA   
Before surgery: Teaching was thorough and understandable, the staff responded to my questions.
5    4    3    2    1    NA   
If awake in surgery: The staff provided adequate information and answers to my questions.
5    4    3    2    1    NA   
If anesthesia was used: My questions were answered adequately.
5    4    3    2    1    NA   
If anesthesia was used: Level of comfort with my anesthesia experience in surgery.
5    4    3    2    1    NA   
I was treated with courtesy and professionalism.
5    4    3    2    1    NA   
Overall experience at Twin Cities Surgery Center.
5    4    3    2    1    NA   
What do you like most about same day surgery?
What do you like least about same day surgery?
Date of surgery
Type of surgery performed
Length of time at the Surgery Center