Title Image

Patient Feedback / Suggestions Form

Home  /  Patient Feedback / Suggestions Form

Patient Feedback/Suggestions Form

Epic Hospital is thankful to you for giving us the opportunity to serve you. To help us in our journey to serve you better we sincerely request you to kindly give us your opinion and suggestions on the treatment provided and services offered at different level by checking the appropriate box. Your identity will remain confidential at all times. We appreciate your feedback and assure you of our best services always.

    FULL NAME


    CONTACT NUMBER


    EMAIL ID



    PROMPTNESS AND COURTEOUS BEHAVIOR OF THE BILLING / RECEPTION COUNTER
    ExcellentGoodAverageBelow AverageUnacceptable


    PLEASE RATE YOUR EXPERIENCE WITH THE CONSULTANT/DOCTOR
    ExcellentGoodAverageBelow AverageUnacceptable


    COURTESY OF THE DOCTOR AND THE NURSING STAFF.
    ExcellentGoodAverageBelow AverageUnacceptable


    TIMELY AVAILABILITY OF THE INVESTIGATION REPORT
    ExcellentGoodAverageBelow AverageUnacceptable


    CLEANLINESS OF THE TOILETS
    ExcellentGoodAverageBelow AverageUnacceptable


    CAFETERIA/F&B SERVICES AT THE HOSPITAL
    ExcellentGoodAverageBelow AverageUnacceptable


    WOULD YOU CONSIDER EPIC HOSPITAL FOR FUTURE MEDICAL NEEDS?
    ExcellentGoodAverageBelow AverageUnacceptable


    WOULD YOU LIKE TO GIVE US ANY MESSAGE?