Procedure Date < September 2010 > Mon Tue Wed Thu Fri Sat Sun 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 8 9 10   Name of Surgeon Assoc. Prof Julian Rait Dr Grant Snibson Dr Maged Atalla Dr Ben Connell Dr Justin Friebel Dr Trevor Gin Dr Wilson Heriot Dr Troy Lim Joon Dr Peter Meagher Dr Salmaan Qureshi Dr David Workman Professor Peter Danne Mr Kevin Spencer Mr Tom Sunderland Mr Tim Brown   ____________________ FINDING US Did you receive a pre-admission phone call from our staff? Yes No   Would you have liked to received a pre admission phone call to better assist you? Yes Not really Possibly No   Was the pre-admission phone call helpful? Yes Sort of Not Really No   How could of the pre admission phone call of been better?   Were you able to locate the Maningham Day Procedure Centre easily? Yes Sort of Not really No   What difficulites did you have in locating us?   Was the signage helpful? Yes Sort of No Can't recall   How could the signage of been better?   Were you able to find a car park easily? Yes Sort of Not really No   At what time of the day did you have difficulties in getting a park?   ____________________ THE ADMISSION Were the reception staff courteous and helpful? Yes Sort of Not really No   How could the reception staff of been better?   Were you happy with the length of time spent before your operation? Yes Sort of Not really No   Approx. how long was your wait after being first admitted? 0-15min 1-1.5 hrs 15-30min 1.5 - 2 hrs 30-45min greater than 2 hrs 45-60min   What were you feelings about having to wait? Did not worry me at all Concerned me a little bit I little frustrated Getting impatient Very impatient Extremely frustrated   Did you feel well cared for by the admission nurse? Yes Sort of Not really No   How could the the care of the admission nurse been better?   ____________________ THE THEATRE Did you feel well cared for by the theatre staff? Yes Sort of Not really No   How could the care of the theatre staff been better?   Did you feel well cared for by the recovery/discharge staff? Yes Sort of Not really No   How could the care of the recovery/discharge staff of been better?   Did you recover from your procedure without any nausea or vomiting? Yes No   What nausea or vomiting did you experience?   Were the discharge instructions clear, easily understood and helpful? Yes Sort of Not really No   Ho could the discharge instructions been better? Were the refreshments served adequate? Yes Sort of Not really No   How were the refreshments not adequete?   Were you happy with the length of time spent after your procedure? Yes Sort of Not really No   How were you not happy with the length of time post operation?   ____________________ A QUICK FINAL RATING Staff friendliness 1 2 3 4 5   Why did you rate staff friendliness so low? Professionalism 1 2 3 4 5   Why did you rate Professionalism so low? Care received 1 2 3 4 5   Why did you rate Care received so low? Ambiance 1 2 3 4 5   Why did you rate the Ambiance so low? My overall experience 1 2 3 4 5   Why did you rate your Overall experience so low? Would you recommend the Manningham Day Procedure Centre? Yes Possibly Not really No   Why would you consider not recommending us?   Level of Insurance Privately insured DVA Self Insured Pensioner Other   What is your level of Insurance(if selected other)?   Any other comments to assist us? May we contact you regarding this information? Yes No   As thanks for your feedback would you like to go into the draw for a weekend indulgence package staying at the Langham hotel? Yes No   Your Name:   Contact Number(s)   Contact email (for draw)