Feedback Form - North West Hospice

North West Hospice provides specialist care with compassion for those living with life-limiting illnesses in our community.

Our values are engendered in the word CARE, which is at the heart of our service:

C for Compassion.
A for Accountability.
R for Respect.
E for Excellence.

North West Hospice welcomes and encourages your feedback on any aspect of the care received in the Service. Your feedback is important to us and will lead to improvements in the way we care for you and those people important to you.

This form can be also downloaded from our website Feedback and Complaints and posted to Ms Nuala Ginnelly, Hospice Manager, North West Hospice, Adelaide Buildings, Wine St. Carpark, Sligo.

Please select as appropriate*

Patient
Family Member
Visitor

Email*

Enter Email Confirm Email

How would you rate our service on the following? (Please tick)

PROFESSIONALISM

COMPLIANCE

COMMUNICATION

RESPECT

CARING

FRIENDLINESS

HELPFULNESS

OPENNESS

We welcome any feedback that might help us improve our service. You are asked to consider the following questions?

1. What worked well?

2. What could be improved on?

3. What should happen every time you or others use this service?

Personal Details (optional)

Name (optional)

Contact Details (optional)

Thank you for taking the time to complete this comment card.

Consent*

Please tick this box if you give your permission for the anonymous use of comments you have made. On occasion, we might like to use some of your comments on our website or other Hospice publications to help promote the Hospice.