SURVEY FOR ENGLISH-SPEAKING PATIENTS

This survey is for English speaking patients only and to provide the hospital with feedback about the quality of our services in English. This is not a mandatory survey but we appreciate your cooperation and information.


PERSONAL INFORMATION
Name
Age
Sex

YOUR ASSESSMENT

1. Please rate the English language service provided by our doctors (their clarity of speech and ability to explain things clearly). In accordance with the order of your examination, rate each doctor individually.
The first doctor:

The second doctor (if any):

The third doctor (if any):


2. Your assessment of the English services provided by our nurses


3. Your assessment of the English services provided by our staff at blood testing area


4. Your assessment of the English services provided by our staff at paraclinical area (MRI, CT, ultrasound, X-ray…)


5. Please describe any frustrations and/or challenges that you experienced with the English of our staff today