If you or your family member has recently been a resident at one of our facilities, we would love to hear any feedback you can provide. Survey results are sent directly to Gary Blake, founder of Creative Solutions in Healthcare.

First name of resident:
Last name of resident:
Which best describes who you are?
Resident, Family member
Name of facility you or your loved one attended:
How long did you or your loved one attend the facility? (insert text box to type number)
Overall, how satisfied are you with the care facility?
Very satisfied - Satisfied – Neutral – Dissatisfied - Very Dissatisfied
How do you rank the quality of Nursing Care? (10 is greatest)
How do your rank the quality of food? (10 is greatest)
How do you rank the cleanliness of the facility? (10 is cleanest)
How likely are you to use our facility again?
Very likely, Probably, Maybe, Probably not, Definitely not, Never
How effective were our rehabilitation programs?
I didn't use your rehab services, Very effective, Effective, Average, Not effective, Completely uneffective
Do you have comments or suggestions that would help us improve our services for residents in the future? (Insert suggestions box)

Sumit button (results sent to gary@creativesolutionsinhealthcare.com)