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Hospital Patient Visit Feedback Form
Thank you for letting us care for you and your loved ones. We would love to hear your thoughts or feedback on how we can improve your experience!
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What is Your Hospital Number?
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Your answer
How would you rate the Customer Service Experience during your visit
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Very Poor
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Excellent
How would you rate your Experience with our Doctors today?
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Excellent
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How would you rate our Laboratory service today?
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Very Poor
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5
Excellent
How would you rate our Pharmacy today?
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Excellent
How would you rate our Nursing Care today?
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Very Poor
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Excellent
Feedback
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Suggestions for improvement
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