Colorectal Surgery

Please answer the questions about your most recent surgery. Do not include other surgeries in your answers.
The survey is anonymous.
You may need to get help from a family member or friend — that’s okay!
Answer all the questions by choosing the response that best describes your experience/feelings.

Thank you for your participation!

Before Surgery

How helpful did you find the information provided to you before your surgery by the surgeon?

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How helpful did you find the information provided to you before your surgery by the nurse?

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How helpful did you find the information provided to you before your surgery by the anesthesiologist (physician who controls your pain and puts you to sleep for surgery)?

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Overall, how prepared did you feel for your surgery?

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How would you describe the amount of education you received before surgery?

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If applicable, how well were any of your other health concerns addressed before surgery?

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How well did you understand what was expected of you to prepare for surgery?

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After Surgery

How well was your pain controlled?

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How well was your nausea controlled?

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10.

How well were your questions or concerns addressed by the surgeon after your surgery?

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11.

How well were your questions or concerns addressed by the nurse after your surgery?

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12.

How well did you understand what was expected of you after surgery?

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13.

How well have your dietary needs been met?

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Preparing for Discharge

14.

How prepared do you feel to leave the hospital?

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15.

How well were your questions about discharge addressed by the surgeon?

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16.

How well were your questions about discharge addressed by the nurse?

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17.

How well educated do you feel about how to care for yourself when you leave the hospital?

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18.

How would you describe your overall satisfaction with the care provided to you?

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19.

Do you know who to contact if you have concerns after your surgery?

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20.

How did your expectations of surgery match your actual experience?

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21.

Do you have any suggestions on how we could improve on the care provided to you?

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22.

Do you have any comments on things we did well?

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23.

Please add any additional comments or suggestions that you feel would be helpful for us to know.

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