Patient Meal Satisfaction Survey

Date*

Patient Name*

Room No.*

1. How would you rate the overall quality of the food provided during your stay?
ExcellentGoodFairPoor

2. How would you rate the taste and flavor of the meals?
ExcellentGoodFairPoor

3. How would you rate the cleanliness and presentation of the food and meal trays?
ExcellentGoodFairPoor

4. Were any of your dietary restrictions or preferences (e.g., Vegetarian, Low-Sodium, Low Fat, Diabetic Diet) adequately met?
AlwaysMost of the timeSometimesNeverNot applicable

5. Did you receive your meals at appropriate and convenient times?
AlwaysMost of the timeSometimesNever

6. How would you rate the friendliness and professionalism of the food service staff?
ExcellentGoodFairPoor

7. Do you have any suggestions to improve the food service at St. Clare’s Medical Center?

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