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How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Medical Services
Hospital Services
Nursing Services
 
 
How satisfied are you with the following:
Very Unsatisfied Unsatisfied Neutral Satisfied Very Satisfied
Doctors
Nursing
Hospitality
Overall
 
 
 
How often do you visit the hospital?
 
2 time a year
 
3 time a year
 
4 time a year
 
5 time a year
 
More than 6
 
 
 
Please drag and rank(1st to 3rd) the following in order of interest:
Drag your choices here to rank them
     
     
    Please rate the following:
    Hospital
    Services
    Medical Care
     
     
     
    Please Enter Phone number
       
     
     
     
    How do you rate your room?
     
     
     
    What is your date of birth?
     
    Survey No. 1