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Hospital Satisfaction Survey (Outpatients)

Is this your first visit or a return visit to the ABC clinic? 

First visit

Return visit

What is the main reason for your visit to the ABC clinic?

Medical staffs shown on TV

Article(s) in newspaper or magazine

Advertisement in newspaper or magazine

Advertisement on TV

Advertisement in the bus or subway

Advertisement on the Internet

Friend or acquaintance recommendation

Good location

Internet search

Review on the Internet

What is the main reason for your revisit to the ABC clinic? (Only applicable for returning customers)

Competence of the medical staff

Friendliness of the medical staff

Friendliness of the employees

Good facilities

Good location

What is your biological gender?



What is your age group?

Under 20

20 ~ 25

26 ~ 30

31 ~ 35

36 ~ 40

41 ~ 45

46 ~ 50

51 ~ 55

56 ~ 60

61 ~ 65

66 ~ 70

Over 70

Were you satisfied with our hospital to recommend us to your friends or colleagues?

Do you intend to continue using our hospital?



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


Short counseling and consultation time

Complicated reservation, reception, payment process

Bad food

No improvement necessary

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


Sufficient counseling and consultation time

Convenient reservation, reception, payment process

Good food

No exceptional areas

Lastly, please feel free to leave any comments, suggestions, commendations, or complaints you may wish to express to our hospital