OUTPATIENT SATISFACTION SURVEY Choose Language : English Indonesian Outpatient Questionnaire Website URL*INSTRUCTIONS FOR COMPLETION Place a checkmark in the box (○) that best corresponds to your experience.Our hospital's physical facilities—encompassing cleanliness, comfort, and the completeness of facilities..*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe reliability of our officers and staff in serving you.*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe Timeliness and speed of the service process you experienced.*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedYour experience with the services provided by our medical staff.Doctor*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedNurse*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedThe friendliness and helpfulness of our officers and staff in serving you.*Very SatisfiedSatisfiedNeutralDissatisfiedVery DissatisfiedAdditionalWould you recommend our hospital to your associates or colleagues?*YesNoYour feedback and appreciation are highly valuable to us. You may share them in this section.Name*Phone No*Date of birth*Medical Record No (Optional)Polyclinic / Services*Silahkan PilihChoose ServicesAcupuncture ClinicPediatric ClinicAnesthesia ClinicPediatric Surgery ClinicDigestive Surgery ClinicOral Surgery ClinicSurgical Oncology ClinicOrthopedic Surgery ClinicPlastic Surgery ClinicNeurosurgery ClinicGeneral Surgery ClinicDermatology ClinicDental ClinicNutrition ClinicCardiology ClinicPsychiatry ClinicObstetrics and Gynecology ClinicEye ClinicPulmonology ClinicInternal Medicine ClinicPsychology ClinicNeurology ClinicTB DOTS ClinicTelemedicine ClinicENT ClinicUrology ClinicSave