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Hello:
We here at The Mercy Family Birthing Center are constantly striving to improve our unit. We would appreciate your feedback on the noise levels and cleanliness of our unit.

Your participation in this study is completely voluntary. Your survey responses will be strictly confidential and data from this research will be used to help us identify problem areas so we can make the necssary changes to improve our unit.

Thank you very much for your time and support.
 
 
What was your room number?
 
_____________
 
 
What was the noise level inside your room (monitors,phones, equipment)?
 
Always loud
 
Most of the time loud
 
About half the time lod
 
Once in a while loud
 
Never loud
 
 
What was the noise level ouside your room (hallways, public areas)?
 
Always loud
 
Most of the time loud
 
About half the time loud
 
Once in a while loud
 
Never loud
 
 
Was there a specific time of day the noise level became to much?
 
________________________
 
How would you rate the cleanliness:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Patient Room/Bathroom:
Hallways:
Waiting Area:
 
 
 
Comments/Suggestions:
   
Thank you for your time and cooperation, helping us improve The Family Birthing Center.
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