* 1. When was your Admission?

Date :

* 2. Was this a planned Admission?

* 3. Which department's of the hospital where you admitted in during your stay?

* 4. How would you rate your stay at Western Private Hospital?

* 5. How likely is it that you would recommend Western Private Hospital to a friend or colleague?

Not at all likely
Extremely likely

* 6. How would you rate your customer service experience at Reception

* 7. Do you think you were given enough information about your hospital stay prior to Admission?