Tuberculosis Clinic Satisfaction Survey
Help us improve our services by sharing your feedback about your recent experience at our clinic.
How would you rate your overall experience at the clinic?
*
1
2
3
4
5
How did you hear about our clinic?
Referred by doctor
Friend or family
Internet search
Social media
Other
Please rate the following aspects of your visit:
*
Rows
Very Poor
Poor
Fair
Good
Excellent
Friendliness of staff
1
2
3
4
5
Professionalism of medical team
6
7
8
9
10
Clarity of information provided
11
12
13
14
15
Cleanliness of facilities
16
17
18
19
20
Privacy during consultation
21
22
23
24
25
How long did you wait before being attended to?
*
Less than 15 minutes
15-30 minutes
31-60 minutes
More than 1 hour
Did you feel your concerns were listened to and addressed?
*
Yes, completely
Somewhat
No, not really
How satisfied are you with the explanation of your diagnosis and treatment?
*
Not satisfied
1
2
3
4
Very satisfied
5
1 is Not satisfied, 5 is Very satisfied
Did you receive information about tuberculosis prevention and follow-up care?
*
Yes
No
Not applicable
Would you recommend our clinic to others?
*
Yes
No
Not sure
What did you like most about your visit?
Do you have any suggestions for improvement?
Please select your age group:
Please Select
Under 18
18-29
30-44
45-59
60 and above
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