Patient Satisfaction Survey

Bright Horizons Home Health Services, Inc.

Please take a few minutes and tell us how we are doing. We appreciate your valuable time and comments.All your responces will be held confidential !

AFHOLA
Association of
Freestanding Home Health
Agency Owners of Los Angeles

For questions 1-10, please circle the appropriate number that best describes your opinion.
	1	2	3	4	5
1. I was satisfied with the care provided by the:
a.) Nurse(s)
b.) Physical Therapist
c.) Occupational Therapist
d.) Speech/Language Pathologist
e.) Medical Social Worker
f.) Certified Home Health Aide
g.) Registered Dietician
2. I was involved in decision-making regarding my plan of care.
3. My option was considered in the planning of discharge.
4. The staff treated me, my family, my home and belongings with respect.
5. The staff explained my conditions, rights and responsibilities,and procedures related to the care I received.
6. The staff generally arrived as scheduled.
7. I was able to reach my nurse/therapist promptly and my phone calls were returned.
8. When I called the agency, the office staff was courteous,available and directed my calls promptly.
9. I would use this agency again.
10. I would recommend this agency to friends and relatives.
11. Suggestions for improvement/additional comments:
12. What most impresses me about the agency’s care/ service was:
Thank you for your valuable feedback. This is confidential and will be used only in efforts to improve care/services. Sincerely, Yvonne Townsend, R.N. Administrator	I would / would not like to discuss my responses further.
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