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Thank you for choosing asiamedical specialists | sportsperformance physiotherapy to serve your healthcare needs. We believe that our CARE for you must be Critical, Analytical, Resource appropriately and Effectively.
To this end, we will be grateful for your time to complete this questionnaire to help us help you. |
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| Is this your first visit ? |
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| Did you make a prior / advance booking for this visit ? |
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| Month | Day | Year | | | | |
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| Hrs. | Mins. | AM/PM | | | | |
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| Please indicate by a tick how you feel about our overall service and our specific service areas and that of your attending professional(s) during your visit here. |
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| Your satisfaction with our Overall Service:
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| Your satisfaction with our Receptionist:
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| * Is your attending professional a Doctor? |
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| Your satisfaction with our Doctor:
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| * Is your attending professional a Nurse? |
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| Your satisfaction with our Nurse:
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| * Is your attending professional a Radiographer? |
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| Your satisfaction with our Radiographer:
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| * Is your attending professional a Physiotherapist? |
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| Your satisfaction with our Physiotherapist:
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| Your satisfaction with our Environment: |
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| Your satisfaction with our Waiting Time
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| If there are any specific areas in which you feel improvement is needed, please add your comments below? | | |
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| Your responses will help us to improve our services. |
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| Would you return for your future healthcare needs? |
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| Would you recommend our services to others? |
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| Please provide your details, if you wish to be contacted to address any concerns that you have. |
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| When is the Suitable Time to contact you? | | |
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