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Hospital Foundation

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Hospital Foundation - Online Survey

Thank you for filling out this survey. Please note that while we will keep all the information you provide confidential, feel free to leave blank any sections you do not wish to answer.


General Information
Name: *required
E-mail: *required
Phone:
Address:

 
Demographics
Residency in Comox
Valley		 26+     10-25     5-9     1-4
Age Group 30-49     50-65     66-74     75+
Use of Hospital Facilities at St. Joseph's General
Please indicate the number of times you and your family have used the services of St. Joseph’s General Hospital in the past TWO YEARS
5+       2-4      1      0

 
Initial Contact with St. Joseph's General Hospital Foundation
( If you are, or have been a donor)
First donation was prompted by:
Other

 
Volunteer Involvement with St. Joseph's General Hospital AND/OR Foundation
At St. Joseph's, have you been a member of a:
Other
Would you like to be involved as a volunteer in the future? Yes     No     Unsure
Comments on Volunteer Involvement:

 
Donor Recognition
Have your donations been acknowledged in an appropriate and timely manner? Yes     No     Unsure     Not a Donor
How do you feel about public recognition? Comfortable    Prefer to be anonymous
Unsure
Are you familiar with the Tree of Life wall in the lobby of the hospital? Yes     No
Is your name listed on this wall? Yes     No
Does this type of recognition appeal to you? Yes     No    Unsure
For the past few years the Foundation has held an annual donor recognition tea at the hospital. Have you: Attended    Declined to Attend

Not been aware of this
Do you think this is appropriate recognition? Yes     No    Unsure
What kind of information would you like to receive at such a function?
Comments on Donor Recognition:

 
Information Updates
Please rate the amount of information you currently receive from St. Joseph's General Hospital Foundation
For the past few years the Foundation has used a twice-yearly centre spread in the local newspapers to keep the community informed as to the equipment and projects funded through their generosity, to highlight existing hospital programs and services and to recognize significant donations.
Do you remember seeing any of these updates? Yes     No
Do you like this method of communication? Yes     No    Unsure
Would you rather have a newsletter delivered to you personally? Yes     No    Unsure
Comments on information updates:

 
Solicitations
Your support is very important to us and we are grateful for your help in enhancing healthcare in the Comox Valley. The hospital operates 24 hours a day, 365 days a year and the needs are ongoing, but we do not want to overload our donors with requests. Please indicate your preference below:
Contact me:
I would like to sign up for automatic deductions from my bank account or credit card account. Yes     No
Please contact me at:
Comments on Solicitations:

 
Internet
Is this your first visit to www.stjosephs-comox.org? Yes     No    Unsure
Would you consider making donations online? Yes     No    Unsure
Would you read an online newsletter? Yes     No    Unsure
 

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