Primary Care Nursing Survey
Please share your feedback about your experiences with primary care nursing services. Your responses are confidential and will help improve care quality.
What is your role?
*
Please Select
Patient
Family Member
Nurse
Other Healthcare Professional
Other
How would you rate the overall quality of nursing care you received or observed?
*
1
2
3
4
5
Please indicate your level of agreement with the following statements about primary care nursing:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Nurses were attentive to my needs
1
2
3
4
5
Nurses communicated clearly
6
7
8
9
10
Nurses showed professionalism
11
12
13
14
15
Nurses respected my privacy
16
17
18
19
20
Nurses provided timely care
21
22
23
24
25
How easy was it to access nursing care when needed?
*
Very easy
Somewhat easy
Neutral
Somewhat difficult
Very difficult
How often did you feel your concerns were listened to by nursing staff?
*
Always
Usually
Sometimes
Rarely
Never
How satisfied are you with the cleanliness and safety of the care environment?
*
1
2
3
4
5
Which aspects of nursing care do you feel need the most improvement? (Select all that apply)
Communication
Timeliness
Professionalism
Privacy
Empathy
Other
How likely are you to recommend this primary care nursing service to others?
*
Not likely
1
2
3
4
5
6
7
8
9
Extremely likely
10
1 is Not likely, 10 is Extremely likely
Please provide any additional comments or suggestions for improvement.
How long have you interacted with or received care from the primary care nursing team?
Please Select
Less than 1 month
1-6 months
6-12 months
More than 1 year
If you would like to be contacted for follow-up, please provide your email address (optional).
example@example.com
Submit Survey
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