Physician Survey

Physician Name:
Practice Location:
How would you rate the responsiveness from the Valley Hospice team on your initial referral?:
How would you rate the communication between you and the Valley Hospice staff?:
How would you rate the quality of care that your patient received from Valley Hospice?:
Does Valley Hospice provide you with the tools and resources that you need to identify hospice eligible patients?:
If we received a less than excellent rating in any category, what could we have done better?:
Do you feel your patients were referred early enough for the patient/family to fully benefit from our service?:
Will you make future referrals to Valley Hospice?:
If no, please tell us what we could have done better to ensure that you would use our service again:
Have you made a referral to Liza's Place Care Center South or Mary Jane Brooks Care Center North?:
Would you like more information about Liza's Place Care Center South, Mary Jane Brooks Care Center North or both?:
Valley Hospice now has 2 ways to help! Would you like information about Caring Connections Palliative Care?:

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