SURVEY INSTRUCTIONS
- You should only fill out this survey if you were the patient with the Hospital.
- Answer all the questions by checking the box to the left of your answer.
Your Waiting Time:
1. During the Hospital visit, How fast did you get to meet the doctor?
2. During the Hospital visit, How often did Receptionist listen carefully to you?
3. During the waiting time, were you comfortably seated?
Nurse Care:
4. During the Hospital visit, how often did Nurse Treat you with courtesy and respect?
5. During the waiting time, were the nurses able to answer your queries patiently and promptly?
6. Post the Doctor visit, were nurse prompt enough to explain and guide you further steps?
Doctor Care:
7. While visiting the Doctor, did he treat you with courtesy and respect?
8. Was the doctor listening to you carefully to understand your problem?
9. Did Doctor ask you enough questions to understand symptoms of your problem?
10. Did Doctor explain the details of the treatment patiently and understandably?
Billing and Insurance:
11. While visiting the Hospital, Did the staff clarify your doubts on the insurance and billing clearly?
12. Did the staff communicate well on the approval policies with the insurer?
13. Were you able to quickly complete the transaction at the billing counter?
Over All General experience:
14. While visiting the Hospital, did you find the hospital environment friendly?
15. Were the bathrooms and Hospital premises clean?
Hospital experience:
16. Using any number from 0 to 10, where 0 is the very bad and 10 is very good, what number would you use to rate this hospital during your stay?
17. Will you recommend the hospital to your friends and family?