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Amrutha Hospitals Feedback Form
We value your opinion and strive to provide the best healthcare service. Please take a few minutes to share your experience with us. Your feedback is confidential and helps us improve.
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Email
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Record my email address with my response
Full Name
*
Your answer
Date of Visit
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MM
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DD
/
YYYY
Department Visited
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Choose
General Medicine
Pediatric
Obstetrics and Gynecology
Fertility and IVF
Laparoscopic Surgery
Hysteroscopic Surgery
Urology
Orthopedics
Menopause Clinic
Doctor's Name (if known)
Your answer
How would you rate your overall experience?
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1
2
3
4
5
How satisfied were you with the following?
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1
2
3
4
5
Cleanliness
Staff behavior
Waiting time
Doctor consultation
Billing experience
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2
3
4
5
Cleanliness
Staff behavior
Waiting time
Doctor consultation
Billing experience
Was the medical staff polite and professional?
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Yes
No
Somewhat
Were your concerns/questions addressed properly?
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Yes
No
Partially
Any suggestions or additional comments?
Your answer
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