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SURVEY
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Name
*
First
Last
Email
*
1. Are you satisfied with the necessary guidance from the intelligence unit on arrival at the hospital?
Excellent
Very Good
Good
Fair
Poor
2. Are you satisfied with the signboards in different parts of the hospital?
Excellent
Very Good
Good
Fair
Poor
3. Are you satisfied with the way IPD employees behave you?
Excellent
Very Good
Good
Fair
Poor
4. Are you satisfied with the waiting length from the time of filing the case to the transfer to the department?
Excellent
Very Good
Good
Fair
Poor
5. Are you satisfied with the way doctors treat you?
Excellent
Very Good
Good
Fair
Poor
6. Are you satisfied with the presence of doctors when needed?
Excellent
Very Good
Good
Fair
Poor
7. Are you satisfied with the training provided by the doctors (during the treatment and discharge)?
Excellent
Very Good
Good
Fair
Poor
8. Are you satisfied with the doctors' answers to your questions?
Excellent
Very Good
Good
Fair
Poor
9. Are you satisfied with drawing the curtain and respecting your privacy while performing medical procedures?
Excellent
Very Good
Good
Fair
Poor
10. Are you satisfied with the way nurses behave you?
Excellent
Very Good
Good
Fair
Poor
11. Are you satisfied with the response time of the nurses to the alarm bell?
Excellent
Very Good
Good
Fair
Poor
12. Are you satisfied with the training provided by the nurses (upon arrival, during treatment and discharge)?
Excellent
Very Good
Good
Fair
Poor
13. Are you satisfied with drawing the curtain and observing privacy while performing nursing activities?
Excellent
Very Good
Good
Fair
Poor
14. If you need diagnostic methods such as radiology, ultrasound, etc., are you satisfied with how it is done?
Excellent
Very Good
Good
Fair
Poor
15. Are you satisfied with the laboratory's diagnostic methods if you need them?
Excellent
Very Good
Good
Fair
Poor
16. Are you satisfied with the way the staff behaves in the diagnostic units?
Excellent
Very Good
Good
Fair
Poor
17. Are you satisfied with privacy when carrying out diagnostic measures?
Excellent
Very Good
Good
Fair
Poor
18. Are you satisfied with the way the service staff behaves and treated you?
Excellent
Very Good
Good
Fair
Poor
19. How satisfied are you with the way you are transferred to the ward or the transfer between different wards of the hospital?
Excellent
Very Good
Good
Fair
Poor
20. Are you satisfied with the cleanliness of the ward?
Excellent
Very Good
Good
Fair
Poor
21. Are you satisfied with the quality and replacement of bedding, blankets and clothes? (copy)
Excellent
Very Good
Good
Fair
Poor
22. Are you satisfied with the amenities (TV, chair, water cooler, telephone, lighting, bed, telephone and prayer hall, cooling status, heating and room ventilation)?
Excellent
Very Good
Good
Fair
Poor
23. Are you satisfied with the quality of the food?
Excellent
Very Good
Good
Fair
Poor
24. Are you happy with the distribution time of food?
Excellent
Very Good
Good
Fair
Poor
25. Are you satisfied with the way the surgery room personnel behave?
Excellent
Very Good
Good
Fair
Poor
26. Are you satisfied with the surgery at the appointed time?
Excellent
Very Good
Good
Fair
Poor
27. Are you satisfied with the necessary information before the surgery?
Excellent
Very Good
Good
Fair
Poor
28. Are you satisfied with the care after the surgery room?
Excellent
Very Good
Good
Fair
Poor
29. Are you satisfied with the performance of the hospital's IPD ward?
Excellent
Very Good
Good
Fair
Poor
30. Are you satisfied with the availability of prescribed drugs?
Excellent
Very Good
Good
Fair
Poor
31. Are you satisfied with the complaints and criticisms of the patients in this hospital?
Excellent
Very Good
Good
Fair
Poor
32. Are you satisfied with amenities in this hospital?
Excellent
Very Good
Good
Fair
Poor
33. Are you satisfied with the way the hospital guards treated you?
Excellent
Very Good
Good
Fair
Poor
34. In general, at what level do you evaluate your satisfaction with hospital services?
High
Medium
Low
35. Do you want to refer to this hospital again if you or one of your relatives need to be hospitalized?
Yes
No
Please write down any criticisms or suggestions if you may have in order to increase the quality level of services and increase satisfaction
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