Ward Patient Satisfaction Survey
Sign in to Google to save your progress. Learn more
Were you taken to theatre for an operation?
Clear selection
After theatre were there any complications?
Clear selection
Has your medical condition improved?
Clear selection
How satisfied are you with the treatment?
Not satisfied
Very satisfied
Clear selection
How satisfied are you with the doctors?
Not satisfied
Very satisfied
Clear selection

How satisfied are you with the nurses?

Not satisfied
Very satisfied
Clear selection
How satisfied are you with the orderlies?
Not satisfied
Very satisfied
Clear selection
How satisfied are you with the food?
Not satisfied
Very satisfied
Clear selection
Is there any one particular staff whose work or attitude is commendable?
Clear selection
If yes, name the staff
Is there any one particular staff whose work or attitude needs improvement?
Clear selection
If yes, name the staff

Is there any other comment or suggestion that you wish to make?

In general how would you rate our health today as compared to when you came for admission
*
Not satisfied
Very satisfied
In general how satisfied are you with the care you received during your admission
Not satisfied
Very satisfied
Clear selection
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