Maxbizz is in the Works!
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IPD Patient Feedback Form
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Name
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Contact Number
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Admission process
Behavior to staff
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5
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2
1
Promptness
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5
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3
2
1
Explanation of estimate
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5
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3
2
1
Response
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3
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1
Consultant/ Doctors
Counseling
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4
3
2
1
Treatment Process
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5
4
3
2
1
Nursing Services
Treatment Explanation
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5
4
3
2
1
Promptness and care
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5
4
3
2
1
Behavior of staff
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5
4
3
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1
Room Comfort
Room facilities
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5
4
3
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Comfort level
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5
4
3
2
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Housekeeping
Cleanliness and unkeep
*
5
4
3
2
1
Behavior of staff
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5
4
3
2
1
Radiology MRI, CT Scan, USG, X-Ray
Service on time
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5
4
3
2
1
Lab Services
Service on time
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5
4
3
2
1
Safety & Security
Behavior of staff
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5
4
3
2
1
Parking Services
*
5
4
3
2
1
Dietary Services
Dietary Counseling
*
5
4
3
2
1
Food & Beverages Services
Quality of food
*
5
4
3
2
1
Service on time
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5
4
3
2
1
Discharge Process
Experience
*
5
4
3
2
1
Billing
Billing Experience
*
5
4
3
2
1
Counseling by Staff
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5
4
3
2
1
Overall Experience
Satisfaction score
*
5
4
3
2
1
Would you recommend us to others?
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Any Comment or suggestion
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