PATIENT SATISFACTION FEEDBACK FORM

Dear Patient/ Relative/ Visitor,

Please take a few minutes to give us feedback about our service by filling in the form. We thank you for your participation.

  • Rate us on a scale of 1 - 5. ( 1 IS THE LOWEST, 5 IS THE HIGHEST)

1)  How satisfied are you with the customer support?

2) How satisfied are you with the timeliness of our service?

3) How satisfied are you with our staff?

a) Nurse

b) Medical Doctor

c) Audiologist

d) Others

4) How satisfied are you with the cleanliness of the hospital?

5) How satisfied are you with the website experience?

6) How would you rate your overall experience with our service?

7) Would you recommend us to Family and friends?

8) What should we change in order to live up to your expectations?