CEMPIA

Hospital Details

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Patient Information

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Date Of Admission
Age
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Clinical & Non-Clinical Departments


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Customer Services	Ambience/Hospital Environment	Doctor	Nursing	Diagnostic	Ancillary

Billing	Health Check-up	Emergency	Cafe	Security	Staff Attitude

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Food & Beverage	Click here to rate
Billing & Discharge	Click here to rate
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Staff Attitude	Click here to rate
Affiliated Services	Click here to rate

Overall Experience

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How did you learn about the hospital ?
Website		Social Media		Another Hospital			Another Doctor		Brochure

Walk in		Campaign		Friends & Relatives			Radio FM		Insurance
Corporate		Other
Any Other Comments & suggestions

Exceptional Staff
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How did you learn about the hospital ?
Website		Social Media		Another Hospital		Another Doctor		Brochure

Walk in		Campaign		Friends & Relatives		Radio FM		Insurance
Corporate		Other
Any Other Comments & suggestions

Exceptional Staff

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Customer Services


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Handling of Appointment

Handling of Enquiries

Telephone Service

Helpfulness

Registration waiting time

Ambience/Hospital Environment(look & Feel)


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Overall Cleanliness

Washrooms

Waiting Area(Lobby)

Parking Services

Doctor Services


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Doctor's explanation

Doctor's Personal Manner (Courtesy, Respect, Sensitivity, Friendliness)

Waiting Time for consultation

Effectiveness of treatment

Nursing Services


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Quality of Care

Nurse's Explanation

Response time

Diagnostic Services


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Services in Dialysis

Services in Cardiology

Services in Endoscopy

Waiting Time for reports / services

Ancillary Services


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Services in Radiology

Services in Laboratory

Services in Physiotherapy

Services in Pharmacy

Billing Services


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Explanation for the bill

Waiting time

Health Check-up & Clinic


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Explanation

Process

Waiting time

Emergency


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Promptness & Responsiveness

Ease of process

Explanation of condition

Cafe


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Quality & Presentation

Service

Security


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Friendliness

Helpfulness

Visibility of security staff

Staff Attitude


Exceeded Expectation	Met Expectation	Did not meet Expectation

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Promptness

Friendliness

Handling of Queries(Knowledgeable)

Greetings and Courtesy

Customer Services
Handling of admission

Explanation of admission process

Handling of Enquiries

Explanation of Expenses/estimate

Room
Cleanliness/Readiness

Temperature control/ Airconditioning

Restroom

TV

Diagnostic & Ancillary Services
Services in Radiology

Services in Physiotherapy

Services in Endoscopy

Services in Cardiology

Services in Emergency & Ambulance

Waiting time for reports/ services

Services in Blood Bank

Nursing Services
Quality of care

Nurse's explanation

Friendliness & Helpfulness

Response time

Services in OT

Doctor Services
Doctor's explanation

Doctor's personal manner/ professionalism

Effectiveness of treatment

Regular progress updates & visits

Food & Beverage
Quality and presentation

Service/ Meal Delivery/Clearance

Response time (Cafe)

Dietican Services

Billing & Discharge
Discharge process

Waiting Time for discharge

Handling of queries

Security
Visibility

Visitor Management

Staff Attitude
Promptness

Helpfulness & Friendliness

Handling of Queries

Affiliated Service
WIFI

Parking

Ambience

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i. using, collecting and/or processing your personal information in accordance with applicable privacy laws in place; or
ii. processing your feedback solely with the objective of improving the quality of our services, unless we obtain your consent or as required by law.