Click here for Spanish [Haga clic aquí para español] You must have JavaScript enabled to use this form. Thank you for allowing us to provide your health care services. We take the opinions of our patients very seriously and we would like your feedback on this experience. Thank you for sharing this information with us. Date (or dates) of Service Based on this experience, would you use Holland Hospital again? Yes No Would you recommend Holland Hospital to your friends and family? Definitely yes Probably yes Probably no Definitely no Using any number from 0 to 10, where 0 is the worst hospital possible and 10 is the best hospital possible, what number would you use to rate Holland Hospital for this service? 10 9 8 7 6 5 4 3 2 1 0 What could we have done to improve this experience for you? Is there a provider, or another person, you would like to acknowledge for exceeding your expectations? Do you have any other comments or suggestions? Name (optional) Phone Number (optional) Class/Program Attended If you wish to speak with a Patient Relations representative, please call (616) 394-3742.