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NPS - Patient Feedback Form

The document is a survey asking a patient about their experience at Amrita Hospital and Research Centre, including questions about how likely they are to recommend the hospital to others and their ratings of various aspects of care like ease of getting an appointment, doctors' experience, and the courtesy and expertise of nurses and technicians. The survey also asks how the patient heard about the hospital and if they would consider it their regular source of care.

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Natasha Bhasin
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2K views1 page

NPS - Patient Feedback Form

The document is a survey asking a patient about their experience at Amrita Hospital and Research Centre, including questions about how likely they are to recommend the hospital to others and their ratings of various aspects of care like ease of getting an appointment, doctors' experience, and the courtesy and expertise of nurses and technicians. The survey also asks how the patient heard about the hospital and if they would consider it their regular source of care.

Uploaded by

Natasha Bhasin
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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NET PROMOTER SCORE

We appreciate you taking the time to tell us about your visist. This information will be held in strictest confidence and will only be sued to
improve the experience and our standard of delivering care to you.

“On a scale of zero (not likely at all) to ten (very likely), how
likely are you to recommend Amrita Hospital and Research Centre
to a friend or colleague

Please elaborate the reason for high/low score:


Overall

How did you come to know about Amrita hospital □ Flyer/Banner/Poster □ Radio/Print Advertisement
□ Website/Internet □ Doctor
□ Family/Friend/Relative

Will you consider this hospital as your regular source of care □ Yes □ No

N/A
Please circle how well we are doing in the following areas: Great 5 Good 4 OK 3 Fair 2 Poor 1 Dont
Know
1 How would you rate the ease of getting an appointment
2 How to rate doctor's experience
3 Were the reports ready at the committed time □ Yes □ No
4 How would you rate the following on their courteousness
i. Nurse
ii. Phelebotomist
iii. Radiology Technician
5 How would rate the following on their technical expertise
i. Nurse
ii. Phelebotomist
iii. Radiology Technician
Comments/Suggestions

Patient/Attendent's Name: UHID No: IPD No:


Phone/Mob No: Email:
Signature: Date:

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