INSIGNIA

Holistic Approach Of Palliative And Geriatric Care

Patient Feedback Form

Hi,

We hope you are well and you have had a fruitful time with us throughout our time together.

We look forward to hearing back from you. Your opinion matters, and we would appreciate if you write to us about your experience with us.

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I look forward to hearing back from you. Your opinion matters, we would appreciate if you write to us of your experience with us.
Please rate us using the scale: 5 = Very Satisfied, 4 = Satisfied, 3 = Neutral, 2 = Dissatisfied, 1 = Very Dissatisfied.
How likely are you to recommend our services to family, friends who are in need of our services?
Please rate us using the scale: 5 = Very Likely, 4 = Likely, 3 = Neutral, 2 = Not really, 1 = Very Dissatisfied.
Did you feel cared for while you were with us?
May we use your Feedback on Social Media, Website?
Please click SUBMIT for the response to get recorded.

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