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Out Patient Feedback Form

Out Patient Feedback Form

Out Patient Feedback Form

Dear Patient / Relative / Visitor,

Your Continuing support & suggestions helps our hospital a better organisation. Kindly spare a few moments to complete the following. So that we can strive to fulfill your expectations.

I came as:

Reason for choosing PSG Hospitals

Any other Reason? (Please Specify)

My experience in PSG Hospital was:

Enquiry & Reception

Registration

Signage boards & Display

OP Reception

Doctors communication

Nurses communication

Billing services

Laboratory services

A.Sample collection

B.Report collection

Radiology Services
(X-Ray,CT,MRI,Ultrasound,Mammogram)

Pharmacy Services

Security Services

Waiting Area

Drinking Water facility

Canteen & Cafeteria

Toilet Facilities

Emergency / Casuality Services

Ambulance facility

Wheel chair & trolley facility

Transport facility

Total Cleanliness

Others if any

Please notify your suggestions for further improvement of our services

Would you like to appreciate any staff for
their outstanding care and services?

Name & Department

Would you consider PSG Hospitals
for your future medical needs ?

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