Hospital Information Questionnaire
Contact Information
Email address *
Hospital Name *
Your answer
Best Email Address *
Your answer
Address *
Your answer
Postal Code *
Your answer
Country *
Telephone Country Code *
Telephone Number *
Your answer
Hospital Website
Your answer
Hospital Email *
Your answer
Main Contact Name/Title/ Email
Your answer
Languages Spoken
Your answer
Is your Emergency/ Acute Care (ER/AC) open 24/7?
What time do visiting hours start during the morning?
Time
:
What time do visiting hours end in the morning?
Time
:
What time do your nightime visiting hours start?
Time
:
What time do your nightime visiting hours end?
Time
:
How many doctors are on staff? (Please include full time and consultant)
Your answer
What percentage of doctors are board certified?
Your answer
What percentage of doctors are trained abroad?
Your answer
Do you have an international patient department?
What percentage of your patients are considered international patients?
Your answer
Do you have technology that reads diagnostic tests performed in other countries?
Which international insurances do you accept?
If your hospital accepts other insurances not listed above please list those insurance company names below:
Your answer
Must foreign patients pay cash prior to treatment?
By which international organizations are you accredited?
If your hospital is accredited by another organization please list it below:
Your answer
From where do you obtain your blood? (ie: Red Cross, local blood bank)
Your answer
From which countries do you primarily obtain your pharmaceuticals?
Your answer
Is parking available at all times?
Please select the specialties your hospital offers:
Average Emergency Room Wait times
If you are a military hospital, do you accept patients serving in other militaries?
Does your hospital have any unique practices/specialties that separates itself from other hospitals in the region or globe? If so, please share below.
Your answer
How many hospitals beds do you have?
Your answer
How many operating rooms do you have?
Your answer
Do you have photos of your hospital you would like to share? Please email photos to: Research@Gauze.net
Please email a copy of your standard or published price lists to: Research@Gauze.net
Your answer
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