Share the Survey:
 Doctor Office Visit Survey
Improving Patient Loyalty
The medical patient survey will help us evaluate our healthcare providers' performance and find out areas that need improvement. The feedback is important for us to know our patients' satisfaction with our services in healthcare.

1.  Please specify your gender.

  Male
  Female


2.  Which age group do you fall into?

  Below 20
  21 to 30
  31 to 40
  41 to 50
  51 to 60
  61 to 70
  70 to 80 and above


3.  How many times have you availed the healthcare facilities offered by our hospital in the past?



4.  In which department were you seen by a health care provider in your recent visit to the hospital?

  Family Practice
  Gynaecology
  Internal Medicine
  Pediatrics
  Rheumatology
  Skincare
  Surgery
Any other, please specify


5.  How much time do you have to usually wait before you can see the healthcare provider?



6.  Are you able to schedule your appointment in a reasonable amount of time?

  Yes
  No
Other


7.  What would you say about the person handling the phone queries?

  Very prompt
  Slow
  Gave the advice needed
  Well informed
  Courteous
  Helpful
  Rude
  Not well informed
Other


8.  How did you find our healthcare provider(s) in the following areas?

ExcellentGoodAverageUnsatisfactoryPoor
He/She listened to your problems and showed concern for those problems
He/She explained the things to you in a way you would understand
He/She was very patient and discussed your problem in detail


9.  What do think regarding the hospital's facilities in the following areas?

Strongly agreeModerately agreeNot sureModerately disagreeStrongly disagree
The staff gives clear information
The staff is well informed and knowledgeable
The appointment times are usually convenient
The interaction with the healthcare providers is good
The billing procedures are hassle free
The referrals to a specialist are handled in a timely way
The patients are the top priority for the hospital staff


10.  What will be the reason for you to refer a friend or family members to our hospital?