Patient satisfaction survey with medical operation
You are?
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Male
Female
What is your age category?
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0-10 years
11-20 years
21-30 years
31-40 years
41-60 years
61-80 years
more
Please rate your satisfaction with following hospital properties
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Definitely satisfied
Rather satisfied
Nor satisfied, nor dissatisfied
Rather not satisfied
Definitely not satisfied
Not related
Cleanness
Transport accessibility
Hospital requirement
Hospital surroundings
Food quality and quantity
Available terms
Please rate your satisfaction with following staff properties
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Definitely satisfied
Rather satisfied
Nor satisfied, nor dissatisfied
Rather not satisfied
Definitely not satisfied
Not related
Nurses approach
Doctors approach
Would you recommend our health institution to family member?
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Definitely yes
Rather yes
Neither yes nor no
Rather not
Definitely not
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