FEEDBACK

PATIENT INFORMATION

I am a *

Name of the Patient *

Contact Number*

Email Id *

Visit Date *

Room Number (If you are an in-patient)

FEEDBACK SURVEY

Reception (Guidance & Response to queries)

Treatment by Physicians / Consultants

Pharmacy

Nursing Staff Care (Attitude & Promptness)

Billing (Response to queries & Promptness)

Cleaning & Hygiene

Overall Courtesy

Name of Staff

Any Other Remarks

Reason

Please rate your experience at Supreme Specialty Hospitals *

4.2/5 - (91 votes)