0 Daily survey Patient Name: Room: Date: Thank you for participating on our experience survey. Over the next several days, we'll be tracking your experience to make key changes to improve our service. Please answer the following wuestions. Did you have any medical administration that required a nurse? YesNo -If yes: did your nurse wear sterile gloves? YesNo - Approximately what time was your administration? Time [time time time-format:HH:mm] Are happy with your doctors? YesNo - How can our doctos better serve you? Did your enemas come at the scheduled time? YesNo - If not, were you informed that they would be a little late? YesNo Did someone bring you 13 juice? YesNo - If not, how many did you receive? Number Did you receive all of your treatments? YesNo - If not, what was missed? - Occasionally, treatments must be rescheduled to postponed in the best internet of the patient, were you advised as to why your treatment was rescheduled or postponted? Is there anything else we can do to make you happy?