Physician Satisfaction Survey
What is your current position in the hospital/office?
Was the equipment you needed are readily available?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Was the nursing staff courteous and professional?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Are you satisfied with the income or salary?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Was the health care staff knowledgeable and helpful?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Kindly rate the hospital admission process
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Is the medical record accurate and on-time?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
How would you rate the promotion process?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
What would you like to see changed to improve and make the process more efficient?
How would you rate the services offered here in this hospital?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Is the plotted schedule for different procedures are in a timely manner (e.g surgery, diagnostic exam)?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Is the number of bed capacity enough versus the incoming admissions?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Is the hospital administration responsive to your needs?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Does the hospital administration cooperate with your ideas or suggestions?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Are the equipment clean and maintained properly?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Are the tools and equipment working or functioning correctly as expected?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
How would you rate the nursing staff in this hospital?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
How would you rate the radiology services?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
How would you rate the diagnostic or laboratory services?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
How would you rate the pathology services?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Do the employees show respect and courtesy to the patients and to co-workers?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Is the customer service helpful and pleasant?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
Is the test results easily accessible for the physicians?
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Unsatisfied
What is your overall rating with this hospital?
1
2
3
4
5
Would you recommend a physician to join this hospital?
Yes
No
Maybe
Comments or suggestions
Do you want to submit anonymously?
Yes
No
Name
First Name
Last Name
Position/Title
Email
example@example.com
Phone Number
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