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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
whats your gender?
 
male
 
female
 
 
 
how would you rate time keeping?
 
excellent
 
very good
 
good
 
fair
 
poor
 
 
 
were you treated with courtesy/respect?
 
excellent
 
very good
 
good
 
fair
 
poor
 
 
 
please indicate service recieved
   
 
 
 
how would you rate the care/treatment you received?
 
excellent
 
very good
 
good
 
fair
 
poor
 
 
 
how comfartable was the setting including the comfort of your room,bed linens etc
NOTE THE SCORING,THE BETTER THE HIGHER THE SCORE
 
1
 
2
 
3
 
4
 
5
 
 
 
how do you like it here overall
 
1
 
2
 
3
 
4
 
5
 
 
 
how do you feel your need are being met or were met?
 
1
 
2
 
3
 
4
 
5
 
 
 
how satisfied are you with the scheduling of the services and activities
 
1
 
2
 
3
 
4
 
5