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SZV Medical Referral Abroad Survey - Clinica De Occidente, Cali
At SZV- Intake
1.
What is your referral number?
(Disclaimer: filling in your referral number is optional but with the referral number SZV can actively follow-up on your behalf)
2.
Did the SZV staff inform you about what you could expect about your medical travel abroad?
(Required.)
Very poor
1 star
Poor
2 stars
Fair
3 stars
Good
4 stars
Very good
5 stars
Comments
3.
Did the SZV staff answer all of your questions to your liking?
(Required.)
Very poor
1 star
Poor
2 stars
Fair
3 stars
Good
4 stars
Very good
5 stars
Comments
4.
Was the SZV staff patient, friendly and helpful?
(Required.)
Very poor
1 star
Poor
2 stars
Fair
3 stars
Good
4 stars
Very good
5 stars
Comments
5.
Did you receive your travel package, including tickets, allowances (this varies per country) at least three days before departure?
(Required.)
Yes
No (please state in comments section when you received your travel package)
Comments
6.
Were you informed during your intake that you should visit your house doctor or treating specialist, with your medical report, when you return to Sint Maarten?
(Required.)
Yes
No
Comments
7.
Please rate how SZV arranged your medical referral abroad
(Required.)
Very poor
1 star
Poor
2 stars
Fair
3 stars
Good
4 stars
Very good
5 stars
Comments
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