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Survey Form


Questionnaire of hospitalized patients and their companions in Jam Hospital

Dear patient, In the hope of good health, please plan your comments for more appropriate medical treatment and improve the conditions of the hospital after completing the following section. Specify your comments in the column beside the questions with the ümark. (This form of information is considered confidential and will not have any negative effect on the services provided to you). Measuring the satisfaction of international hospitalized patients survey

Date of hospitalization
Passport Number
Full Name
Nationality
Email
Phone Number
Please, make suggestions and criticisms about improving the quality of hospital services.

1-Are you satisfied with the way IPD employees behave you?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

2-Are you satisfied with the way doctors treat you?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

3-Are you satisfied with drawing the curtain and respecting your privacy while performing medical procedures?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

4-Are you satisfied with the signboards in different parts of the hospital?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

5-Are you satisfied with the way nurses behave you?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

6-Are you satisfied with the training provided by the nurses(upon arrival, during treatment and discharge)?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

7-If you need diagnostic methods such as radiology, ultrasound, CT scan, etc., are you satisfied with how it is done?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

8-Are you satisfied with privacy when carrying out diagnostic measures?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

9-Are you satisfied with the cleanliness of the ward?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate 😠

10-Are you satisfied with the surgery at the appointed time?

Excellent 😀
Good 🙂
Suitable 😕
Inappropriate ðŸ˜