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 dapat
meningkatkan 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
    Doctor
    Waiting Time
    Medicine & Services


    4. Your overall experience in this clinic? *
    Bagaimanakah pengalaman anda di klinik ini?


    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?


    8. Phone Number *
    Nombor Telefon