Feedback
 
* denotes compulsory fields
 
Salutation :
* Name :
Date of Visit :
Address :
Contact no. :
* Email :
* Clinic Branch :
Is this your first visit to this branch?


Please rate your experience with us by selecting a rating that
most closely matches the service level experienced.

Excellent Good Satisfactory Poor Very poor
5 4 3 2 1

   
Registration
Promptness of Service
Clarity in Communication
Medical Consultation
Proficiency of Doctor
Clarity in Explanation of Diagnosis
Laboratory
(only applicable in Republic Plaza Branch)
Proficiency of Phlebotomist
Demonstration of Care
Dispensary
Promptness of Service

Clarity in Explanation of Instructions for Dispensed Drug
 
General Environment
Cleanliness of Facility
Maintenace of Facility
Comfort of Waiting Area
Service Level 
Waiting Time
Demonstration of Care by Clinic Staff
Grooming Standards of Clinic Staff
Overall Experience
How Would You Rate Our Services?
 
Please share your comments and suggestions on how we can serve you better