Hospital Food Service Satisfaction Survey
Patient Name
Room Number
Date
Food Quality
How would you rate the taste of the food?
Excellent
Good
Fair
Poor
How would you rate the variety of the menu?
Excellent
Good
Fair
Poor
How would you rate the temperature of the food when served?
Excellent
Good
Fair
Poor
Service Quality
How would you rate the courtesy of the food service staff?
Excellent
Good
Fair
Poor
How would you rate the promptness of meal delivery?
Excellent
Good
Fair
Poor
How would you rate the accuracy of your meal orders?
Excellent
Good
Fair
Poor
Comments / Suggestions
Please share any comments or suggestions:
Would you recommend our food services to others?
Yes
No