Patients Feedback - Erebouni Medical Center

Kindly provide your objective rating for the following parametrs on the following scale of 1 to 5

1= Poor 2 = Average 3 = Good 4 = Very Good 5 = Excellent

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2

3

4

5

1

How you will rate the waiting time in the reception area

2

Rate the friendliness and courtesy of the receptionist

3

Rate the caring concern of our nurses/medical assistants

4

Rate the professionalism of our nurses

5

How much you satisfied with the helpfulness of the people who assisted you with billing or insurance

6

How you will rate the professionalism of our lab or other diagnostic service staff

7

Your test results reported in a reasonable amount of time

8

How you will rate the professionalism of your attending physician

9

How you will rate the complеteness and availability of explanation regarding your condition, diagnostic/therapeutic procedure given you by your attending physician

10

How you will rate amount of time your attending physician had spent with you

11

How much you are satisfied with the work of your attending physician

12

How you will rate the thoroughness of the examination in our Center

13

How much completely our physicians give the instructions regarding medication/follow-up care

14

How you will rate the quality of your medical care in our Center

15

How you will rate the medical equipment facilities in our Center

16

How you will rate your satisfaction with our facilities

17

Rate the hospital stay general condition

18

How much you satisfied with the hygiene level in the Center

19

How you would recommend our Center to others

If there is any way that we can improve our services to you? Please tell us about it:*

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You are new patient Return visit
First name	Surname
Age	Sex
Address	Phone
E-mail	Your education
Date of admission	Date of discharge
Clinic	Department
Attending physician’s name ×
You are new/ reterning patient*
1	2
3	4

Patient feedback form