PATIENT SATISFACTION SURVEY

Please take a few moments to complete this survey to help us to serve you better

Name *

LLH No *

Service Availed *

Date of Visit *

Gender *

Male Female

Date Of Birth *

Mobile *

Email



How satisfied were you with the following aspects of our care?

* Ease of Booking an appointment

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Customer Care Services

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Nursing Services

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Medical Care

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Diagnostic Services

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Overall Waiting time

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Cleanliness

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied

* Facility and Ambience

Very Unsatisfied

Unsatisfied

Neutral

Satisfied

Very Satisfied


What do you like best about our care center?

What do you like least about our care center?


Your Suggestions



Would you recommend us?
Yes No



Would you use our center in the future?