This customizable document, Patient Satisfaction Survey - Individual Comment Report Form, is taken from MCN Healthcare’s Human Resources Manual. For more than 20 years, MCN has been the health care industry’s leading provider of policy and procedure templates, forms, competencies and other compliance tools.

MCN provides more than 80 health care specific policy and procedure manuals for Acute Care Hospitals, Ambulatory Care, Behavioral Health, Home Health, Physician Practice, and Long Term Care. MCN’s policy and procedure manuals focus on the latest healthcare "hot topic" issues related to patient safety and prevention of medical healthcare errors.

Here is some sample content from Patient Satisfaction Survey - Individual Comment Report Form:

	PATIENT SATISFACTION SURVEY INDIVIDUAL COMMENT REPORT Comments are transcribed as written by the patient. Department Patient Questionnaire Comments Manager Response/Action No identification No identification Admitting Admitting Business Office Business Office Cardiopulmonary Cardiopulmonary Clinical Laboratory Clinical Laboratory Emergency Department Emergency Department Engineering Engineering Environmental Services Environmental Services Imaging/Radiology Imaging/Radiology Outpatient Surgery Outpatient Surgery Patient Care Unit Patient Care Unit Pharmacy Pharmacy Physical Therapy Physical...
Second excerpt:
	...Laboratory Emergency Department Emergency Department Engineering Engineering Environmental Services Environmental Services Imaging/Radiology Imaging/Radiology Outpatient Surgery Outpatient Surgery Patient Care Unit Patient Care Unit Pharmacy Pharmacy Physical Therapy Physical Therapy Social Services Social Services Miscellaneous Miscellaneous ?? ?? ?? ?? 1 Reference #1310 Human...