When was your most recent healthcare visit?
What type of visit was it?
- Emergency department
- Inpatient hospital stay (overnight)
- Outpatient clinic or urgent care
- Telehealth/virtual visit
Overall, how would you rate the care you received during this visit?
Did you have pain during this visit?
Please rate your agreement with the following statements about pain management during this visit:
Which methods were used to manage your pain? Select all that apply. If you had no pain, choose "None".
- Oral medication
- IV or injection medication
- Ice or heat
- Positioning or movement
- Relaxation or breathing techniques
- Other
- None
How well did staff listen to you during this visit?
How clear was the information you received about your condition or care?
Did staff give you enough time to ask questions?
- Yes, definitely
- Yes, somewhat
- No
Attention check: To help us ensure data quality, please select "No".
Before you left, how much did you agree with the following?
How confident did you feel managing your care after discharge?
Which supports did you receive before leaving? Select all that apply.
- Written instructions provided
- Demonstration or teach-back used
- Follow-up appointment scheduled
- Prescription(s) arranged before leaving
- Transportation support provided
- Home care or community support arranged
- None of the above
- Not applicable
What is your age group?
- 18–24
- 25–34
- 35–44
- 45–54
- 55–64
- 65–74
- 75 or older
- Prefer not to say
How do you describe your gender? Select all that apply.
- Woman
- Man
- Non-binary
- Another gender identity
- Prefer not to say
What is your current employment status?
- Employed full-time
- Employed part-time
- Self-employed
- Unemployed
- Student
- Retired
- Unable to work
- Prefer not to say
What could we have done to improve your experience during this visit?
Max 600 chars
AI Interview: 2 Follow-up Questions on your visit
Thank you for completing this survey.