Feedback - Life Care International Hospital

info@lifecareinternationalhospital.com.pk

051-111-111-161

LIFE CARE INTERNATIONAL HOSPITAL

Patient Name *

Room / Ward

MR No *

Date

Department Visited OPD IPD Emergency (ER) Diagnostic Services

Consultant / Doctor Name

Rating Scale: 1 = Poor | 2 = Fair | 3 = Good | 4 = Very Good | 5 = Excellent

Service Area Component	1	2	3	4	5
Registration / Admission Process
Waiting Time for Consultation / Treatment
Courtesy of Front Desk Staff
Doctor's Communication & Explanation
Doctor's Professional Competence
Nursing Care (if applicable)
Emergency Response Time (ER patients)
Cleanliness of Hospital
Cleanliness of Washrooms
Behavior of Support Staff
Diagnostic Services (Lab/Radiology)
Billing & Payment Process
Overall Quality of Care

1. Were hospital staff respectful and courteous? Yes No

2. Did the doctor explain your condition clearly? Yes No

3. Did you receive timely care and attention? Yes No

4. Were the hospital facilities comfortable? Yes No

5. Would you recommend Life Care International Hospital to your family and friends? Definitely Yes
Probably Yes
Not Sure
No

Overall Satisfaction Engine Rating Very Dissatisfied Dissatisfied Neutral Satisfied Very Satisfied

What did you like most about our services?

What improvements would you suggest?

Any complaint or concern?

How likely are you to recommend Life Care International Hospital to others? (0-10)

0 1 2 3 4 5 6 7 8 9 10

May we contact you regarding your feedback? Yes No

Contact Number * (Format: 11 Digits)

Email Address * (Must include @)