Sabzevar Heshmatie Hospital

Heshmatie Hospital

Patient Satisfaction Survey

We would like to know how you feel about the services we provide so we can make sure we are meeting your needs.
Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous.
Thank you for your time.

Your Age:
*


Your Country:
*

Your Sex: male Female

Full Name:(Optional)


Please circle how well you
think we are doing in the
following areas
:
GREAT
5

GOOD
4
OK
3
FAIR
2

POOR
1

Ease of getting care:
Ability to get in to be seen
Hours Center is open
Convenience of Center’s location
Prompt return on calls
Waiting:
Time in waiting room
Time in exam room
Waiting for tests to be performed
Waiting for test results
Staff: Provider: (Physician, Dentist, Physician Assistant, Nurse Practitioner)
Listens to you
Takes enough time with you
Explains what you want to know
Gives you good advice and treatment
Nurses and Medical Assistants:





Friendly and helpful to you
Answers your questions

Please circle how well you think we are doing in the following areas:





All Others:





Friendly and helpful to you
Payment :





What you pay
Explanation of charges
Collection of payment/money
Facility:





Neat and clean building
Ease of finding where to go
Comfort and Safety while waiting
Privacy
Confidentiality:





Keeping my personal information private
Do you consider this center your regular source of care? Yes No










What do you like best about our center?




What do you like least about our Center?




Suggestions for improvement?




Thank you for completing our Survey!
متن درون تصویر را در جعبه متن زیر وارد نمائید 
*