PATIENT’S EXPERIENCE
1. How many times have you been in TMCC in the past as a patient? PATIENT’S EXPERIENCE
a. This is my first time 1. How many times have you been in TMCC in the past as a patient?
b. 2 to 3 times a. This is my first time
c. More than 3 times b. 2 to 3 times
2. Reason for choosing The Medical City Clinic c. More than 3 times
a. Accessibility / Proximity 2. Reason for choosing The Medical City Clinic
Residence a. Accessibility / Proximity
Office Residence
b. Quality of Service Office
c. Doctors b. Quality of Service
d. Credibility / Trusted c. Doctors
e. HMO Accredited d. Credibility / Trusted
f. Nurse / Staff e. HMO Accredited
g. Good Facilities / Equipment f. Nurse / Staff
h. Recommended by Families / Friends g. Good Facilities / Equipment
3. Your comments and suggestions are most valued. Please accomplish h. Recommended by Families / Friends
our feedback form from using the following rating scale: 3. Your comments and suggestions are most valued. Please accomplish
4 – Very Satisfactory our feedback form from using the following rating scale:
3 – Satisfactory 4 – Very Satisfactory
2 – Unsatisfactory 3 – Satisfactory
1 – Very Unsatisfactory 2 – Unsatisfactory
*STAFF 1 – Very Unsatisfactory
a. Physician *STAFF
b. Nurse a. Physician
c. Medtech b. Nurse
d. Radtech c. Medtech
e. Cashier d. Radtech
f. Receptionist e. Cashier
*SERVICES f. Receptionist
a. Schedule *SERVICES
b. Waiting Time a. Schedule
c. Orientation on Procedure b. Waiting Time
d. Conduct of Procedure c. Orientation on Procedure
e. Cost d. Conduct of Procedure
*FACILITIES e. Cost
a. Waiting Area *FACILITIES
b. Procedure / Treatment Area a. Waiting Area
c. Restroom b. Procedure / Treatment Area
Reasons for returning back to the Clinic c. Restroom
Reasons for returning back to the Clinic
Please tell us about more about your experience at The Medical City Clinic
a. Who among our clinic staff provided you with exceptional service? How Please tell us about more about your experience at The Medical City Clinic
did he/she did so? a. Who among our clinic staff provided you with exceptional service?
How did he/she did so?
b. How likely are you to recommend the clinic to your family/friends?
Least Likely 1 2 3 4 b. How likely are you to recommend the clinic to your family/friends?
Least Likely 1 2 3 4
Most Likely 5 6 7 8
Most Likely 5 6 7 8