PATIENT SATISFACTION SURVEY

At North Texas Anesthesia we are constantly trying to improve on the care of our patients. We would appreciate it if you would take a few minutes and answer the questions to our satisfaction survey.


Did you have a day surgery procedure? 
Yes No

Did your anesthesiologist try to call the night before your surgery
Yes No

Did you feel you had adequate time prior to your surgery to speak with your anesthesiologist?  
Yes No

Did you experience any nausea or vomiting after your anesthetic? 
Yes No

If you did, when? 
Recovery room Hospital room Car ride home Next day

How well was your post-operative pain controlled?
Not Very Somewhat Very Well

How satisfied are you with your overall anesthesia care?
Not Very Somewhat Very Well


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