S.C. CADEROM S.R.L.
RO | EN

EVALUATION QUESTIONNAIRE OF PATIENT SATISFACTION

Evaluation of work done
1. How would you rate the overall quality of medical services performed?
very goodgoodsatisfactoryunsatisfactory

2. How do you assess the work of our doctors and nurses teams?
- careful with medical equipment in working area

very goodgoodsatisfactoryunsatisfactory
- considerate with patients
very goodgoodsatisfactoryunsatisfactory
- clean, appropriate hygienic conditions
very goodgoodsatisfactoryunsatisfactory
- quality of medical examinations
very goodgoodsatisfactoryunsatisfactory

3. Medical services performed meet your requirements:
- general characteristics

very goodgoodsatisfactoryunsatisfactory
- performance
very goodgoodsatisfactoryunsatisfactory

4. How do you rate:
- elapsed time in the waiting room?

very goodgoodsatisfactoryunsatisfactory
- price?
very goodgoodsatisfactoryunsatisfactory
- readiness to carry out medical act?
very goodgoodsatisfactoryunsatisfactory
- quality of medical equipment and reagents used?
very goodgoodsatisfactoryunsatisfactory

5. How would you assess the cooperation with SC CADEROM SRL:
- the response of medical staff to the needs expressed by you?

very goodgoodsatisfactoryunsatisfactory
- technical information on medical activity performed?
very goodgoodsatisfactoryunsatisfactory
- responding to your requests / comments during the carrying out of medical services?
very goodgoodsatisfactoryunsatisfactory

6. Where did you learn last time about SC CADEROM SRL?
newspaper
radio
leaflets
other patients
tv
internet
banners
other sources

7. Do you intend to collaborate in future whith SC CADEROM SRL?

yesno

8. Do you accept the visit of other patients for references to medical or diagnostic services performed by our company?

yesno

9. Proposals to improve collaboration with SC CADEROM SRL:


The questionnaire was completed by:
Name:
First name:
Function:
Age:
Diagnosis / medical service performed:
Company name: