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Customer Feedback



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Dear Everyone,
We very much appreciate hearing from our patients, visitors, and other customers.
Please use this form to provide us feedback on the following:
 
  • Our Services: please let us know if our services need improvement along with any suggestions you might have.
  • Safety Concerns: please let us know if you notice anything you feel we should address to make our hospital and clinic a safer environment.
  • Ethical Concerns: please let us know if you notice anything you feel is an ethical issue that should be addressed by the Hospital's Ethics Committee.
 
These forms are collected by our Total Quality Management team every day and routed to staff members best able to respond to feedback received. However, if you'd like the feedback considered confidentially by either the Hospital CEO or the Hospital’s Ethics Committee, please indicate this on the form.
 
If you'd like to receive a response to your feedback, please indicate this on the form. If you would like to suggest via email, please feel free to write us at [email protected] . We thank you very much for your feedback.
 
Warm regards,
The Hospital Management Team

 
Date of Visit* :
Clinic or Area Visited* :
Type of Comment :
Title* :
Would you like us to contact you about your feedback?
Email : *
First Name :
Last Name :
Nationality :
*
You are :
Phone :
We encourage you to give us feedback on our hospital and services that you have received. Your comments and feedback will be strictly confidential and will be used to help us improve our quality and services.

Patient Hospital Number :
Title* :
Message* :