We would appreciate your taking a few minutes to complete the questionnaire below. When you are finished simply click the send button and your reply will be sent directly to our Service Excellence Manager.

Feel free to express your opinions frankly. Please be assured that your comments and recommendations will make a difference. Thank you for your help.

At which Blanchard Valley Health System facility did you seek medical treatment? Blanchard Valley Hospital Bluffton Hospital Physicians Plus Well At Work Birchaven Carey Medical Center McComb Medical Center Ottawa Medical & Diagnostic Ada Medical & Diagnostic North Baltimore Medical & Diagnostic

Would you recommend Blanchard Valley Health System to family or friends? Definitely Yes Probably Yes Probably Not Definitely Not

How much were you helped by the care you received? Poor Fair Good Very Good Excellent

How was the overall quality of care and services? Poor Fair Good Very Good Excellent

How helpful was the staff in reducing or eliminating any pain you might have had? Poor Fair Good Very Good Excellent

How would you rate the explanations provided about signs and symptoms to watch for? Poor Fair Good Very Good Excellent

How would you rate the explanations provided about medications and side effects? Poor Fair Good Very Good Excellent

Name (OPTIONAL)   Phone Number (OPTIONAL)   Email (OPTIONAL)

Do you have any comments about your last visit, or your overall experience with Blanchard Valley Health System? Please send us your comments.