226 Whetherburn Drive
Wexford, PA 15090

Patient Satisfaction Survey

To complete and submit the patient satisfaction survey please choose the form below. 

Please check which facility provided your anesthesia care:
Waterfront Surgery Center
The Surgery Center at Edgeworth Commons
South Hills Surgery Center
Date of procedure:

Overall, how would you personally rate your anesthesia care?
Excellent Good Average Poor

How would you rate the professionalism and competence of your anesthesia team?
Excellent Good Average Poor

Were you interviewed promptly by the anesthesiologist or nurse anesthetist assigned to your care?
Yes No Comments:
Was your privacy maintained during your pre-operative evaluation by anesthesia personnel?
Yes No Comments:
Were you given the opportunity to ask questions regarding your anesthetic care management?
Yes No Comments:
How easy was it for you to communicate with the anesthesiologist or nurse anesthetist?
Easy Somewhat Easy Difficult Impossible
How likely are you to recommend Waterfront Anesthesia Associates to a friend or family member:
Very Likely Likely Unlikely Not Sure

Please list any areas which our anesthesia services could be improved.

Is there anything else you would like to share with Waterfront Anesthesia Associates about your experience today or your anesthesia care in general?
Check here and complete the information below if you would like a representative from Waterfront Anesthesia Associates to contact you.
Name:   Phone:   Email:

Thank you. Waterfront Anesthesia Associates is committed to ensuring your privacy as a patient. You can be confident that we do not sell or exchange names, email addresses or any other personal information about our patients with third parties.