What is the main reason for the patient's (and your) decision to have surgery or inpatient treatment at the ABC clinic?
Competence of the medical staff
Friendliness of the medical staff
Friendliness of the employees
Good facilities
Good location
Cost competitive
Recommendation of a friend or acquaintance
Fame or reputation of the hospital
What is your gender? (Not patient's)
Male
Female
What is your age group? (Not patient's)
Under 20
20 ~ 25
26 ~ 30
31 ~ 35
36 ~ 40
41 ~ 45
46 ~ 50
51 ~ 55
56 ~ 60
61 ~ 65
66 ~ 70
Over 70
What is the patient's current status?
Hospitalized to prepare for surgery
Recovering from a surgery
Hospitalized for non-surgical treatment
Were you satisfied with our hospital to recommend us to your friends or colleagues?
Do you wish the patient to continue using our hospital?
Yes
No
Please select all area where our hospital needs improvement
Unfriendly employees
Unfriendly doctors
Less skilled doctors
Lacking or old facilities
Dirty hospital
Inconvenient parking
Difficult to find
Long wait time
Expensive
Short counseling and consultation time
Complicated reservation, reception, payment process
Bad food
No improvement necessary
Lack of facilities for patient guardians
Please select all area where our hospital is exceptional
Friendly employees
Friendly doctors
Skilled doctors
Good facilities
Clean hospital
Convenient parking
Easy to find
Short wait time
Inexpensive
Sufficient counseling and consultation time
Convenient reservation, reception, payment process
Good food
Good facilities for patient guardians
No exceptional areas
Lastly, please feel free to leave any comments, suggestions, commendations, or complaints you may wish to express to our hospital