Patient Experience Feedback Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.How would you rate the services provided by the reception staff, including ease of check-in wait times? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorWhich doctor did you see during your visit? *Which sessions do you plan to attend? *Follow upConsultationHow would you rate the doctor's ability to explain your diagnosis and treatment plan? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorHow would you rate the doctor's professionalism and bedside manner? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorHow would you rate the nurse's responsiveness and ability to address your needs? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorHow would you rate the nurse's professionalism and communication during your visit? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = Poor ability Medical treatment How would you rate the cleanliness and comfort of the waiting area and other facilities? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorHow would you rate your overall experience at Ibn Sina Medical centre? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 55 Star = Excellent | 4 Star = Very Good | 3 Star = Good | 2 Star = Fair | 1 Star = PoorHow likely are you to recommend Ibn Sina Medical Centre to family and friends? *Not at all likelyExtremely likelyWhat suggestions do you have for improving your experience at Ibn Sina Medical Centre? *Submit
