Patient Acceptance and Discharge Survey Form

Drawing on divine guidance and blessings of our Prophet (PBUH), he informs Pars Hospital to design questionnaires for different departments in order to measure clients' satisfaction and identify their strengths and weaknesses in providing better services. The results of the poll will be released to the authorities in general. Please help us to serve you more accurately.

Patient information
Please carefully read the following and rate your satisfaction by selecting the appropriate score from the drop-down list (score 0 means very negative opinion about you, score 10 means very positive opinion, score 5 means moderate opinion, and others scores If you cannot comment on something, leave the field blank.
Patient admission and discharge Questions
Please choose between one to ten numbers in answer to the following questions