Provide Feedback on Your Service

Our goal at Suburban Hospital is to provide our patients with the highest quality healthcare combined with exceptional service. One of the best ways to do this is to ask our patients about their experience so we can identify what we are doing right and areas that may need improvement.

We have a formal survey process whereby patients are randomly selected to receive a satisfaction survey by mail. To expand that process, we now offer our patients and family members a chance to offer feedback here on our Web site. You may also use this online opportunity to identify staff members that provided exceptional care to you.

If you receive a survey in the mail, we appreciate your completing and returning it. You can also request that a survey be mailed to you by calling our Office of Customer Relations at 301.896.2000. Please be sure to provide the patient’s name and date and type of service received (Emergency, Inpatient, Outpatient, Surgery, etc.).

The Office of Customer Relations is a direct link to the hospital’s Administrative Office. If you wish to file a complaint or grievance, please call at 301.896.2000 or write to 8600 Old Georgetown Road, Bethesda, MD 20814. For more information, please refer our Patient Handbook.

First Name:
Last Name:
Patient Name:
Date of Admission or Service	01 02 03 04 05 06 07 08 09 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2008 2009
Relationship to Patient:	Self Parent Brother Sister Other Relative Friend Other
Is the patient aware you are contacting the hospital:	Yes No
Patient's Doctor:
Unit Where the Patient Stayed: (Ex: 4300 or Oncology)
Hospital Department: (Ex: Radiology or Joint Center)
Your Preferred Response Method:	Phone Email Mail
City, State, Zip
Feedback: