Youth Hospital Experience Survey
Help us improve hospital care for young patients by sharing your honest feedback about your recent hospital experience.
Your Age
*
Your Gender
*
Male
Female
Non-binary
Prefer not to say
Other
What was the reason for your hospital visit?
*
Please Select
Surgery
Accident/Emergency
Ongoing Treatment
Routine Check-up
Other
How long was your most recent hospital stay?
*
Less than 1 day
1-3 days
4-7 days
More than 1 week
Overall, how would you rate your hospital experience?
*
1
2
3
4
5
Please rate the following aspects of your hospital experience:
*
Rows
Excellent
Good
Average
Poor
Friendliness of staff
1
2
3
4
How well staff listened to you
5
6
7
8
Clarity of explanations given
9
10
11
12
Cleanliness of hospital
13
14
15
16
Feeling safe and respected
17
18
19
20
Did you feel involved in decisions about your care?
*
Yes, always
Yes, sometimes
No
Were your questions and concerns taken seriously by hospital staff?
*
Yes, always
Yes, sometimes
No
What did you like most about your hospital experience?
What could be improved to make the hospital better for young patients?
Would you recommend this hospital to other young people?
*
Yes
No
Not sure
Submit Feedback
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