NHCS
OUTPATIENT SERVICES Feedback Form
  
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it is confirmed that you have read, understood and consented to the SingHealth Data Protection Policy,
a copy of which is available at www.singhealth.com.sg/pdpa

Hard copies are available upon request.
  

To help us improve our patients experience, we would like to hear from you.

Please provide your answers to the following questions about your visit at our Specialist Outpatient Clinic.

If this is your first visit to our clinic/center, please answer these questions based on your experience today.

  
  
You visited*
  
Counter Staff
1. How often did the Counter Staff
a. treat you with courtesy and respect?
  
b. explain things in a way you could understand?
  
Medical Technologists
2. How often did the Medical Technologists
a. treat you with courtesy and respect?
  
b. listen carefully to you?
  
c. explain things in a way you could understand?
  
d. treat you with kindness and compassion?
  
3. How often did you have confidence and trust in the Medical Technologists providing care to you?
 
Nurses  
4. How often did the nurses
a. treat you with courtesy and respect?
  
b. listen carefully to you?
  
c. explain things in a way you could understand?
  
Doctors
5. How often did the doctors
a. treat you with courtesy and respect?
  
b. listen carefully to you?
  
c. explain things in a way you could understand?
  
Consult Room Staff
6. How often did the consult room staff
a. treat you with courtesy and respect?
  
b. explain things in a way you could understand?
  
Your other experiences
7. Did you understand the symptoms and health problems to look out for after your visit?
  
8. Common areas are clean
  
9. Toilets are clean
  
10. Would you recommend NHCS to your friends and family if they needed similar treatment?
  
11. On the whole, I am satisfied with my visit.
  
12. If there is one key area that NHCS has impressed you, what will it be?
  
13. If there is one key area that NHCS could improve on, what will it be?
  
14. The waiting time for consultation / tests is satisfactory?
 
Commendation for Quality Service  
If our staff has served you well, please tell us about it.
Name of Staff:
  
Clinic/Department:
  
Describe the service act that has made an impression on you.
  
Name of Patient:
  
NRIC Number:
  
Contact Number:
  
Date of Visit:*
  
Your Name and Contact Number (if you are not the patient):