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On-line Neonatal Parent Survey

* Indicates required information

Please provide the following information to help us best serve you.

First Name *
Last Name *
Email *
Street *
City *
State *
Zip *
Phone *

1.
The NICU was easy to locate.
           
2.
While visiting my baby in the NICU, there was a comfortable place to sit.
           
3.
The NICU was clean.
           
4.
While in the NICU, I felt that my baby was safe from outsiders.
           
5.
I felt that adequate time was given to prepare for discharge.
           
6.
I felt prepared to take my baby home when he/she was discharged from the NICU.
           
7.
The discharge process was not rushed.
           
8.
I understood all of the tests and treatments my baby received.
           
9.
I understood all of my baby's conditions.
           
10.
I felt that my family participation was encouraged.
           
11.
I was comfortable with the family visitation process.
           
12.
The Neonatologist frequently informed me about my baby's progress during his/her hospitalization.
           
13.
The Neonatologist explained my baby's condition and the treatment and tests he/she received in a clear and understandable manner.
           
14.
I felt comfortable asking the Neonatologist for information regarding my baby's progress.
           
15.
The Neonatal Nurse Practitioner (NNP) frequently informed about my baby's progress during his/her hospitalization.
           
16.
The NNP explained my baby's condition and treatment and tests he/she received in a clear and understandable manner.
           
17.
I felt comfortable asking the NNP for information regarding my baby's progress.
           
18.
I felt comfortable approaching NICU staff to obtain further information regarding my baby's progress.
           
19.
I knew the appropriate NICU staff member to approach when I needed additional information.
           
20.
NICU staff encouraged me to approach when I needed additional information.
           
21.
NICU staff encouraged me to actively participate in my baby's care.
           
22.
I participated in decisions about my baby's care.
           
23.
I felt that I was part of the team caring for my baby.
           
24.
The Billing staff was helpful and courteous
           
25.
The Billing statement was easy to understand.
           
26.
I was made aware of all Billing procedures.
           
27.
During your baby's hospital stay, did any member of the NICU staff go above and beyond to provide excellent care to both you and your baby?
           
28.
Do you have any suggestions for future improvements?
           
29.
General comments
30.
Would you like to be contacted to discuss your survey response?
           
31.
If so, please provide us with a contact number and the best time to reach you.

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