Well-Life Hospital
Book Now!

Patient Feedback Form

We value your feedback and are committed to continuously improving your experience at Well-Life Hospital.

WELL-LIFE HOSPITAL Patient & Visitor Experience Feedback Form

Your feedback helps us improve our services. This survey takes less than 5 minutes to complete.

WELL-LIFE HOSPITAL Patient & Visitor Experience Feedback Form

SECTION A: VISIT INFORMATION

(Helps us understand your experience better)

SECTION B: SECURITY / GATE EXPERIENCE

Please rate the following:

SECTION C: RECEPTION & WAITING AREA EXPERIENCE

Please rate the following:

SECTION D: NURSING CARE (If Applicable)

Please rate the following:

SECTION E: MEDICAL OFFICERS (DOCTORS) (If Applicable)

Please rate the following:

SECTION F: LABORATORY SERVICES (If Applicable)

Please rate the following:

SECTION G: PHARMACY SERVICES (If Applicable)

Please rate the following:

SECTION H: INPATIENT CARE (If Applicable)

Please rate the following:

SECTION I: OVERALL EXPERIENCE

Please rate the following:

SECTION J: OPEN FEEDBACK

Please rate the following:

SECTION K: FOLLOW-UP (Optional)

Your responses are completely anonymous.
Sharing your contact details is optional and only needed if you would like us to follow up on your feedback.

Stacy

I'm here to assist you.

Hi there, I'm Stacy, your dedicated support agent at Well-Life Hospital. Need assistance? Click the button below to chat with me on WhatsApp.

Scroll to Top