Feedback - Dr Mohan's Diabetes Center in Chennai

Patient / Attender Name *

M. No. *

Branch *

Visit Date *

Phone *

Email

Kindly rate our services for the below mentioned attributes. Feedback to be given only for services availed, and the rest can be left blank

1. Registration / Admission formalities:

Please give your inputs for improvement

2. Phone call handling (Call Centre / Appointment):

Please give your inputs for improvement

3. Guidance of PRO/GRO:

Please give your inputs for improvement

4. Billing:

Please give your inputs for improvement

5. Laboratory & Blood collection:

Please give your inputs for improvement

6. Investigations (ECG/ Doppler / Biothesiometry / Foot examination):

Please give your inputs for improvement

7. Diabetes class & Diet advice:

Please give your inputs for improvement

8. Doctor's Secretary:

Please give your inputs for improvement

9. Diagnosis & Treatment:

Please give your inputs for improvement

10. Surgical Dressing

Please give your inputs for improvement

11. Nursing Care (Only for In-patients):

Please give your inputs for improvement

12. Operation Theatre (Only for In-patients):

Please give your inputs for improvement

Other Specialities:

1. Eye:

Please give your inputs for improvement

2. Fitness/Physiotherapy:

Please give your inputs for improvement

3. X-ray:

Please give your inputs for improvement

Your ratings on:

1. Adherence to doctor's appointment time:

Please give your inputs for improvement

2. Homecare:

Please give your inputs for improvement

3. Catering services:

Please give your inputs for improvement (copy)

4. Pharmacy service:

Please give your inputs for improvement

5. Footwear:

Please give your inputs for improvement

6. Insurance:

Please give your inputs for improvement

7. Cleanliness:

Please give your inputs for improvement

8. Electrical & Plumbing:

Please give your inputs for improvement

9. Security:

Please give your inputs for improvement

Your suggestions/appreciations please

Feedback given by: *

Relationship to Patient: *