Hospice del Valle Caregiver Feedback
An important part of our Hospice program is the evaluation of how well we are meeting the needs of those we serve. Hospice del Valle is committed to providing the highest quality of care. Your honest feedback about our performance and your overall Hospice experience will help us do just that. We would appreciate if you could take a few minutes to complete this feedback form.

We realize this may be a difficult time for you, and reflecting on your loved one’s last weeks and days may be emotional for you, but we hope that when you are ready, you will respond. We encourage you to answer only the questions that you are comfortable responding to.

Know that you are in our thoughts and prayers. You have our sympathy in the loss of your loved one.

Sincerely,

The Staff of Hospice del Valle

Email address *
2) If you had important questions regarding your loved one's condition or treatment, were you able to reach someone to answer your questions?
3) Were the answers that staff provided to your questions presented in a way that you could understand?
4) How would you rate the skills of our staff in meeting or exceeding your expectations?
5) How satisfied were you with the courtesy of the staff that treated you/your loved one?
6) How would you rate the availability of Hospice del Valle staff and volunteers?
7) Did you/your loved one feel that you were treated with respect and dignity?
8) In regards to your loved one's care, do you feel that the staff worked together?
Poor
Excellent
9) In regards to your loved one's care, how well do you feel the staff communicated with one another?
Poor
Excellent
10) Overall, how satisfied were you with the treatment and care your loved one received from Hospice del Valle?
11) Would you recommend Hospice del Valle to your family or friends?
12) If you answered no on question #11, could you please explain?
13) Do you have further comments or impressions that you would like to share?
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