We would love to hear your thoughts or feedback on how we can improve your experience!Kami ingin mendengar pendapat atau maklumbalas anda tentang bagaimana kami dapatmeningkatkan prestasi kami!
1. I visited: * Saya mengunjungi:
2. Which doctor did you see? *
3. Please rate the following: * Sila nilaikan yang berikut:
Clinic environment ExcellentGoodFairBadVery Poor
Nurses ExcellentGoodFairBadVery Poor
Doctor ExcellentGoodFairBadVery Poor
Waiting Time ExcellentGoodFairBadVery Poor
Medicine & Services ExcellentGoodFairBadVery Poor
4. Your overall experience in this clinic? * Bagaimanakah pengalaman anda di klinik ini? 012345678910
5. Comments/Suggestions Komen/Cadangan
6. Name * Nama
7. Would you like a Qualitas Customer Service representative to contact you? * Adakah anda ingin Perkhidmatan Pelanggan Qualitas menghubungi anda? YesNo
8. Phone Number * Nombor Telefon
