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


Signage boards & Display

OP Reception

Doctors communication

Nurses communication

Billing services

Laboratory services

A. Sample collection

B. Report collection

Radiology Services

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

Wheel chair / Trolley facility

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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