Anaesthesia Survival Form

After your operation I would like to invite you to provide me with a feedback about your anaesthetic experience. Your answers give me the opportunity to optimise my anaesthetic service. I appreciate your help.

How satisfied are you with your anaesthetic experience?

How satisfied are you with the pre-anaesthetic assessment?

How satisfied are you with the management of your anxiety?

How satisfied are you with the management of your pain?

How did you feel BEFORE your operation?

Fine

in pain

anxious

How did you feel AFTER your operation?

How can your anaesthetist improve your anaesthetic experience?