FEEDBACK PATIENT INFORMATION I am a * Patient Attender Visitor 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) Excellent Very Good Good Satisfactory Poor Treatment by Physicians / Consultants Excellent Very Good Good Satisfactory Poor Pharmacy Excellent Very Good Good Satisfactory Poor Nursing Staff Care (Attitude & Promptness) Excellent Very Good Good Satisfactory Poor Billing (Response to queries & Promptness) Excellent Very Good Good Satisfactory Poor Cleaning & Hygiene Excellent Very Good Good Satisfactory Poor Overall Courtesy Excellent Very Good Good Satisfactory Poor Name of Staff Any Other Remarks Reason Please rate your experience at Supreme Specialty Hospitals * Excellent Very Good Good Satisfactory Poor Submit 4.5/5 - (74 votes)
