Cardiac Rehabilitation Patient Satisfaction Survey
Patient Information
Name
Age
Gender
Male
Female
Other
Prefer not to say
Satisfaction with Cardiac Rehabilitation Program
How satisfied are you with the overall program?
Very Satisfied
Satisfied
Neutral
Unsatisfied
Very Unsatisfied
The staff was professional and courteous
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
The facility was comfortable and clean
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
Was the information provided clear and easy to understand?
Yes
No
Did the program meet your expectations?
Yes
No
What could be improved?
Additional Comments