Postoperative Survey
Name: (optional)
Age:
  Park Ridge Anesthesiology Associates strives to deliver the best level of medical care and satisfaction. From our patients input on our service, we have been able to improve our care and our institution into what it is today. We take your feedback into account and use it to make our practice better for everyone.

  Please read the questions and mark from 1 (worst) to 5 (best)on the scale provided. Comments are greatly appreciated.

1. How would you classify your surgery?
  Minor (brief)  Intermediate  Major (prolonged)
PREOPERATIVE CARE:
2. Was the information regarding your anesthesia care properly explained by your anesthesiologist?
  (worst) 1  2  3  4  5  (best)
 Comments:
3. Do you feel that your anesthesiologist effectively responded to your questions and concerns?
  (worst) 1  2  3  4  5  (best)
 Comments:
4. Do you feel that your anesthesiologist listened to your pre-surgical specific problems?
  (worst) 1  2  3  4  5  (best)
 Comments:
5. How would you rate the overall courtesy of your anesthesiologist?
  (worst) 1  2  3  4  5  (best)
 Comments:
POSTOPERTIVE CARE:
6. Did your anesthesiologist perform a nerve block to help control your postoperative pain?
  Yes  No 
7. How well did your anesthesiologist control your postoperative pain along with any other uneasiness that you may have experienced?
  (worst) 1  2  3  4  5  (best)
 Comments:
8. Did you experience any nausea or vomiting?;
  Yes,  No

-If yes, did you receive treatment for nausea or vomiting? Yes,  No

--If yes, was this treatment effective? Yes,  No

 Comments:
9. How satisfied were you with your POSTOPERATIVE treatment?
  (worst) 1  2  3  4  5  (best)
 Comments:
10. What is your opinion of the overall care that you received from your anesthesiologist?
  (worst) 1  2  3  4  5  6  7  8  9  10 (best)
 Comments:
11.What aspects of your pre and post surgical care do you believe could be improved by your anesthesiologist in order to provide a better experience?
 Comments:
12.In the future, if you had the option to allow a Park Ridge anesthesiologist care for you during an operation, would you be comfortable with this doctor or want your care from an alternate organization?
 Yes No
 Comments: