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CorsoCare Hospice Bereavement Survey - DNU

When you provide your feedback, you allow CorsoCare Hospice to better support families like you in the future. That’s why we ask that you take a few moments to complete our Hospice Bereavement survey regarding your experience. Thank you!

Validation

1. In which state did your loved one receive CorsoCare Hospice services? *This question is required.

2. Please select your age range

3. What is your zip code?

4. What is your relationship to your loved one that received services from CorsoCare Hospice?
I am his/her:

Please enter an 'other' value for this selection. * This question is required.

5. How long were our hospice services provided to your loved one?

6. Overall, how satisfied are you with the bereavement services that CorsoCare Hospice provided?

7. How would you rate the grief support hospice mailings you received?
(consider content and timing)

8. Is there anything that you would have liked more information on that you did not receive in the mailings?

8. How would you rate the grief support phone calls you received?

9. What could we do to improve the bereavement phone calls you received?

9. How would you rate your experience with any calls you made to our grief support team?

10. How could we have provided a better experience during phone calls you made to our team?

10. Would you prefer more monthly phone calls instead of mailings?

11. How helpful was the in-person grief support provided by our hospice bereavement team?

12. What could we do to improve the in-person bereavement visits?

12. What did you find most helpful or beneficial to your grief journey?

13. How likely is it that you would recommend CorsoCare Hospice to a friend or colleague?

	0	1	2	3	4	5	6	7	8	9	10
Not at all likely	0	1	2	3	4	5	6	7	8	9	10	Extremely likely

14. What is the main reason for your score?

15. Please share any additional feedback about your experience with CorsoCare Hospice bereavement services