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