FEEDBACK FORM

Help us serve you better. We value your opinion and want to consider your inputs in further improving the services we provide in your hospital.

This survey will take about 30-45 seconds to complete. We would appreciate your participation. The items marked by a red asterisk (*) indicates required information.

YOUR DETAILS
Name :
*Patient Identification Number (PIN) :
*Email Address :
PATIENT SATISFACTION SURVEY
Department : Plastic, Reconstructive and Cosmetic Surgery

Name of Doctor
Prof. Gaston Schwarz

Details of hospital visit :
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Excellent
Good
Satisfactory
Unsatisfactory
 
 
*1. How professional was our staff?
 
 
*2. How was our service?
 
 
*3. How well did our staff attend to you?
 
 
*4. How accommodating and friendly were our staff?
 
 
Comment/Suggestions:
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