Feedback

Fill up the below form for your Feedback.

Name :
Pateint ID :
Email :
Your Last Visit :
From where you get the information about our hospital :
Your experience while you registered at the reception? :
Willingness of the staff members in clearing your doubts and Hospitality you received? :
Were you treated with dignity and respect by our doctors? :
Are you satisfied with the advice and required instructions from the doctors? :
How satisfied were you with the outcome of your treatment? :
What I liked :

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Will you recommend this hospital to your friend or family ? :

I will recommend this hospital to my friend or family
I will Not recommend this hospital
I do not want to express my opinion
What could have been improved :

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If you are not satisfied with our services, do you wish to be contacted for a follow up? :

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Please summarize your overall experience at our Hospital :

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Would you like to convey your appreciation to any staff/Department? :

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