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Patient / Companion Survey Form

This questionnaire is designed to assess your satisfaction with the services provided at the hospital.

It is obvious that your attention to detail in answering the questions will greatly contribute to enhancing the quality of services at the hospital.

Patient First and Last Name
Gender(Required)
Marital status(Required)
Satisfaction with the Behavior and Responsiveness of the Doctors:
Behavior of Hospital Security Personnel with You:
Level of Care and Service Delivery by Nurses:
Attitude and Responsiveness of Nursing Staff:
Cleanliness and hygiene of the ward, patient room, and restroom:
Satisfaction with food quality, distribution timing, and service:
Attitude of the reception staff and the time spent on patient admission:
Level of satisfaction with the physical condition of the hospital (calmness, lighting, noise, ventilation, and facilities for companions):
Level of satisfaction with the time spent on patient discharge:
Thank you for your cooperation: Parsa Hospital Management