Excellent
Poor
1. How would you rate the level of care while at CountrysideHRC?
5
4
3
2
1
2. Rate your level of overall satisfaction with your visit at CountrysideHRC.
5
4
3
2
1
3. Rate the level that you would recommend CountrysideHRC to other family members or friends. 5 would be a strong recommendation.
5
4
3
2
1
4. How would you rate the cleanliness of our facility?
5
4
3
2
1
5. Rate our level of care compared to other skilled nursing facilities. If applicable.
5
4
3
2
1
Name(Optional):
E-mail Address(optional):
Comments(optional):
Short-Term Care
Letter From Administrator
In-house Newsletter
Admissions
Online Survey
Key Staff
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