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ਪੰਜਾਬੀ / पंजाबी / پنجابي
Patient Feedback Survey
This survey consists questions that allows medical doctors to gather feedback from patients regarding their overall experience with the clinic.
Question 1*
Name of Clinic/Doctor
Question 2*
What is your gender?
Question 3*
Overall satisfaction
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Doctor Knowledge
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Doctor Kindness
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Nurse Patience
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Nurse Knowledge
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Waiting Time
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Hygiene
Very satisfied
Satisfied
Neutral
Unsatisfied
Very unsatisfied
Question 4*
How can we improve our service?
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