JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Client Satisfaction Survey
Thank you for choosing Sunway Home Healthcare, the only hospital-based healthcare at home service in Malaysia. We appreciate the chance to meet you and to attend to your clinical need(s). Can we hear from you? Please spare a moment to help us improve our care to you and/or your family.
We welcome our long term clients to share your renewed view from time to time.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
About our Care Coordinator
Our care coordinator is the first person who explains our services and introduces our care provider(s) to you. She answers your questions related to hospital discharge and arrangement for home care.
You were attended timely, as per appointment via phone call or in person
Yes
No
Clarity of overview on home care initiation and services involved:
Need improvement
1
2
3
4
Very good
Clear selection
When inquired, pricing and payment information were explained in detail.
*
yes
No
Have you noticed the pricing of medical supply been made affordable to our home care patients?
*
Yes
No
Maybe
About our Care Providers
The care provider is a nurse, a dietitian, a physiotherapist or a medical officer from Sunway Home Healthcare. We are Malaysian, licensed/ professionally trained to provide skilled services to you and your family members.
Your nurse explained the care/tools used on you every time when you needed it:
*
yes
No
Not applicable
Required
Your therapist explained the care/tools used on you every time when you needed it:
*
yes
No
Not applicable
Required
Your nurse explained the type and purpose of medication/procedure to be given:
yes
No
Not applicable
Were you satisfied with the consultation by your dietitian/doctor?
Yes
No
Not applicable
Clear selection
Overall, were you satisfied with the services provided by Sunway Home Healthcare?
Yes
No
Not applicable
Clear selection
Would you agree that Sunway Home Healthcare staff and services are reliable and dependable?
Yes
No
Maybe
Clear selection
Would you recommend Sunway Home Healthcare to your relatives and friends?
Yes
No
Clear selection
Do you wish to complement any staff for his/her outstanding care and services? If yes, please list the name(s) and any comment:
Your answer
Do you consent to let Sunway Home Healthcare quote your complement / recommendation on our website or social media? Your full name will not be published, only surname.
An example: "Ms Chong (Penang):
Wanie is a very dedicated wound care nurse. I highly commend her for her professionalism and dedication to care for my mom "
*
Yes
No
How can we improve further?
Your answer
About the patient and you
How did you find out about us?
Doctor's recommendation
Family / friend's recommendation
Previous service experience at Sunway Medical Center
Brochure/ Flyer/ Poster
Other:
Clear selection
Name of Patient:
*
Your answer
This feedback is completed by:
Your answer
Relationship to Patient:
Self
Spouse/ Child/ Parent
Relative/ Friend
Clear selection
Contact number:
Your answer
Town (Place of Stay)
Your answer
Area/Zip Code
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
