Share Your Experience with the CEO

Hi,
I'm Dave Fielding, CEO of Hospice of Palm Beach County and Hospice of Broward County. I want you to know that I consider it an honor to have the chance to serve every single family we care for - to be with you in a time that is both so difficult, and so meaningful. We all share that sentiment. Because of this, we want you to have the chance to tell me directly about your hospice experience - from the wonderful details to those that were concerning to you. When you submit it, please know that I receive every one of the notes below, even if you do not hear back from me directly. I will read it, and I hold a very high value on reading what you would like to say.

Sincerely,
Dave

Please share the wonderful aspects of your experience. If possible, please include specific names and examples so that we can make sure the correct people receive your thank you.

Please share any concern or comment. If possible, please include specific names and examples so that we can improve our service.

Before submitting this form, I have worked with my Hospice Care Team staff to find a resolution to my concern:

	* required
* I have already talked to my Nurse, Social Worker, C.N.A., Chaplain, or other appropriate team member to raise my concerns.
* I have already talked to my Team's Supervisor regarding my concerns.
* My Team Supervisor has already had a chance to consult with my team's Hospice Care Physician regarding my concerns.
* Full Name:
* Phone Number where I can be reached:	(i.e. 5618485200)
* Full Name of Hospice Patient:
* Email Address:
* Confirm Email Address: