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FEEDBACK

The document is a client feedback form for Asher Imaging and Medical Diagnostic Center, consisting of multiple questions regarding the affordability, accuracy, staff demeanor, waiting time, and cleanliness of the facilities. Each question allows clients to respond with a 'Yes' or 'No' and provides space for additional comments and suggestions. The form is repeated multiple times, indicating a structured approach to gathering client feedback.

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praytapales
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© © All Rights Reserved
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62 views1 page

FEEDBACK

The document is a client feedback form for Asher Imaging and Medical Diagnostic Center, consisting of multiple questions regarding the affordability, accuracy, staff demeanor, waiting time, and cleanliness of the facilities. Each question allows clients to respond with a 'Yes' or 'No' and provides space for additional comments and suggestions. The form is repeated multiple times, indicating a structured approach to gathering client feedback.

Uploaded by

praytapales
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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1.Are the Laboratory test affordable?

ASHER IMAGING AND MEDICAL ( ) YES ( ) NO


DIAGNOSTIC CENTER 2. Are the test accurate and complete?
( ) YES ( ) NO
CLIENT’S FEEDBACK FORM 3. Are the staffs cheerful, ethical and courteous?
( ) YES ( ) NO
1.Are the Laboratory test affordable? 4. Is the waiting time short?
( ) YES ( ) NO ( ) YES ( ) NO
2. Are the test accurate and complete? 5. Are the clinical facilities clean and hygienic?
( ) YES ( ) NO ( ) YES ( ) NO
3. Are the staffs cheerful, ethical and courteous?
( ) YES ( ) NO COMMENT & SUGGESTIONS:
4. Is the waiting time short? _________________________________________________________
( ) YES ( ) NO _________________________________________________________
5. Are the clinical facilities clean and hygienic? _________________________________________________________
( ) YES ( ) NO

COMMENT & SUGGESTIONS: ASHER IMAGING AND MEDICAL


_______________________________________________________ DIAGNOSTIC CENTER
_______________________________________________________
_______________________________________________________ CLIENT’S FEEDBACK FORM

1.Are the Laboratory test affordable?


ASHER IMAGING AND MEDICAL ( ) YES ( ) NO
DIAGNOSTIC CENTER 2. Are the test accurate and complete?
( ) YES ( ) NO
CLIENT’S FEEDBACK FORM 3. Are the staffs cheerful, ethical and courteous?
( ) YES ( ) NO
1.Are the Laboratory test affordable? 4. Is the waiting time short?
( ) YES ( ) NO ( ) YES ( ) NO
2. Are the test accurate and complete? 5. Are the clinical facilities clean and hygienic?
( ) YES ( ) NO ( ) YES ( ) NO
3. Are the staffs cheerful, ethical and courteous?
( ) YES ( ) NO COMMENT & SUGGESTIONS:
4. Is the waiting time short? ________________________________________________________
( ) YES ( ) NO ________________________________________________________
5. Are the clinical facilities clean and hygienic? ________________________________________________________
( ) YES ( ) NO

COMMENT & SUGGESTIONS:


________________________________________________________ ASHER IMAGING AND MEDICAL
________________________________________________________ DIAGNOSTIC CENTER
________________________________________________________
CLIENT’S FEEDBACK FORM

1.Are the Laboratory test affordable?


ASHER IMAGING AND MEDICAL
( ) YES ( ) NO
DIAGNOSTIC CENTER
2. Are the test accurate and complete?
( ) YES ( ) NO
CLIENT’S FEEDBACK FORM
3. Are the staffs cheerful, ethical and courteous?
( ) YES ( ) NO
1.Are the Laboratory test affordable?
4. Is the waiting time short?
( ) YES ( ) NO
( ) YES ( ) NO
2. Are the test accurate and complete?
5. Are the clinical facilities clean and hygienic?
( ) YES ( ) NO
( ) YES ( ) NO
3. Are the staffs cheerful, ethical and courteous?
( ) YES ( ) NO
COMMENT & SUGGESTIONS:
4. Is the waiting time short?
_________________________________________________________
( ) YES ( ) NO
_________________________________________________________
5. Are the clinical facilities clean and hygienic?
_________________________________________________________
( ) YES ( ) NO

COMMENT & SUGGESTIONS:


________________________________________________________
________________________________________________________
________________________________________________________

ASHER IMAGING AND MEDICAL


DIAGNOSTIC CENTER

CLIENT’S FEEDBACK FORM

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