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Service Opinion Survey Form

Service Opinion Survey Form

Service/ Admission Date:
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N/A
1）
Friendliness of staff
2）
Professionalism of staff
3）
Patient journey (e.g. admission, consultation, investigation, discharge)
4）
Holistic / Spiritual care
5）
Quality of environment (e.g. hygiene, lighting, temperature, quietness, privacy, security)
6）
Quality of facilities (e.g. waiting areas, wards, lavatories, linens, catering, barrier-free facilities)
7）
Clarity of information (e.g. our contact method, signage, service / charge information, Patients' Charter, channels for providing feedback, webpage)
8）
Reasonableness of charges
9）
Overall impression on our hospital
10）
Comparison with other public / private hospitals
11）
Would you choose our service again?
Yes
No
N/A
12) Staff / service commended by you
13) Areas we should improve
Your personal information (optional)
Please enter your email address if you would like to receive a copy of the service feedback survey.
Thank you very much for your invaluable opinion!
  1. Every precious survey form will reach our hospital management and the involved wards / departments for follow up. Positive comments encourage our staffs to keep up with their good services whereas recommendations / negative comments help us improve.
  2. If necessary, we may contact you for more information to facilitate our follow up (if you provide us with your name and telephone number).

May God Bless You
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Please enter required fields and provide at least one evaluation of the above opinions. Your valuable opinions and suggestions will help us to continuously improve.
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