Patient Satisfaction Survey Dear Guest,We want to be sure we are doing everything we can to serve you. Please take a minute to fill out this confidential survey. Just let us know what we are doing well and what we can do better! Amina Hospital Management Patient Satisfaction Survey Form Please enable JavaScript in your browser to complete this form.Name *FirstLastMobile Number *Staff 1. Courteousness & Friendliness *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied2. Proper Communication *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied3. Explanation of Test and Treatment *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied4. Explanation of Medical Treatment *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery DissatisfiedOthers 1. Facility and Equipments *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied2. Parking Facility *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied3. Comfort of Waiting Area *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied4. Clarity of clinic Internal Signs *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied5. Visual Appeal *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied6. Convenience of Location *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied7. Overall Cleanliness *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied8. Privacy *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied9. Waiting Time *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery Dissatisfied10. Pharmacy *Very SatisfiedSatisfiedNeither Satisfied nor DissatisfiedDissatisfiedVery DissatisfiedRemarksHow likely is that you would recommend Amina Hospital to a friend, family or colleague? *012345678910Submit