Patient Satisfaction Feedback Survey Question Title * 1. Date of your visit Date Date Question Title * 2. Full Name Question Title * 3. Phone Number Question Title * 4. Email Question Title * 5. Please indicate which Zens Medical Center provided services to you: Nadi Denarau Lautoka Ba Rakiraki Labasa Savusavu Sheraton Tokoriki Fiji Marriott Resort Question Title * 6. Which service(s) would you like to rate? Ambulance General Consult Pathology Radiology EMR Physiotherapy Emergency Care Immigration Medical In-patient \Observation Services Question Title * 7. With 5 being the most, rank how satisfied you were with the waiting time 1 2 3 4 5 1 2 3 4 5 Question Title * 8. How satisfied were you with the following aspects of Zens Medical Centres? Very Disappointed Disappointed Neutral Satisfied Very Satisfied Customer Service Customer Service Very Disappointed Customer Service Disappointed Customer Service Neutral Customer Service Satisfied Customer Service Very Satisfied Waiting Time Waiting Time Very Disappointed Waiting Time Disappointed Waiting Time Neutral Waiting Time Satisfied Waiting Time Very Satisfied Results Turn Around Time Results Turn Around Time Very Disappointed Results Turn Around Time Disappointed Results Turn Around Time Neutral Results Turn Around Time Satisfied Results Turn Around Time Very Satisfied Directions after Procedures Directions after Procedures Very Disappointed Directions after Procedures Disappointed Directions after Procedures Neutral Directions after Procedures Satisfied Directions after Procedures Very Satisfied Information Provided to you Information Provided to you Very Disappointed Information Provided to you Disappointed Information Provided to you Neutral Information Provided to you Satisfied Information Provided to you Very Satisfied Question Title * 9. Were you made aware of your position in the queue and the estimated wait times? Yes No Question Title * 10. Did the team offer clear direction after the procedures were completed? Yes No Not Applicable Question Title * 11. Did the relevant procedural departments attend to your preferences and worries? Yes No Question Title * 12. Were you encouraged to share your feedback? Yes No Question Title * 13. What was the most positive aspect of your experience at our hospital? Question Title * 14. Please provide any additional comments or suggestions Question Title * 15. How would you rate your experience with Zens Medical Cantres overall? 1 2 3 4 5 1 2 3 4 5 Question Title * 16. How likely is it that you would recommend Our Hospital to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title * 17. For any urgent matter please contact Done
