Satisfaction questionnaire

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Health services assessment questionnaire

Dear Sir/Madam,

In order to continuously improve the services we offer, we kindly ask you to rate the degree to which our services meet your requirements and expectations.

Please rate on a scale of 1 to 5 (1 = unsatisfactory, 2 = satisfactory, 3 = good, 4 = very good, 5 = excellent), marking with an "X" in the appropriate column, the degree to which each of the following statements applies to you. If you wish to characterize in other words or comment on our team please fill in the blanks.

    1 / 13

    2 / 13

    Attitude of reception staff

    Admission procedure

    Explaining patients' rights and obligations

    Explaining the costs of investigations/hospitalization

    3 / 13

    Clean

    Accommodation conditions

    Food appearance and quality

    4 / 13

    He gave me the attention and respect due to a patient

    He showed solicitude

    He answered the questions I asked

    Showed interest and got involved in solving/improving my health condition

    5 / 13

    He gave me the attention and respect due to a patient

    He showed solicitude

    He answered the questions I asked

    Showed interest and got involved in solving/improving my health condition

    6 / 13

    ...diagnosis, possible treatment, associated risks

    ...the risks of an operation/investigation indicated by the attending physician

    ...consequences of possible refusal of treatment/operation

    ...how the medical investigation/operation will go

    ...method of administering medicines

    7 / 13

    Discharge procedures (discharge note, prescription, sick leave, medical letter)

    Information for recovery and care

    8 / 13

    9 / 13

    10 / 13

    11 / 13

    12 / 13

    13 / 13