Resident satifaction survey

Name: _________________________Room:_________ Date: ___________________ Diet

Type: _____________________ Texture:________Preference:__________

Thank you for participating in our survey your feedback is important

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Resident Name: _________________________Room:_________ Date: ___________________ Diet Type: _______________ Texture:________Preference:___________
Thank you for participating in our survey. Your feedback is important

Resident Satisfaction
Name: _________________________Room:_________ Date: ___________________ Diet Type: _____________________ Texture:________Preference:___________
Thank you for participating in our survey. Your feedback is important

Do you require a specialized diet?

yes

No

Not sure

Does the weekly standard menu adequately accommodate your dietary requirements?

Yes

No

Not sure

Indicate
your level of satisfaction with the current meal choices that meet your dietary requirements

Indicate your level of satisfaction with the current meal choices that DO NOT meet your dietary requirements.

Very satisfied

Somewhat satisfied

Unsatisfied

Very unsatisfied

Indicate
your level of satisfaction with the current meal choices that meet your dietary requirements

Are you able to get snacks between meals that meet your dietary requi

Yes

No

Not sure

Do you have any suggestions or comments regarding the meal choices at Briton House.

Yes

No

Were you satisfied with the quality and temperature of your meal?

Where you satisfied with the quality and temperature of your meal?

In general how would you rate the overall satisfaction of the meals at . Briton house?