Study to identify service attribute that determine customer choice of hospitals.

A survey on customer satisfaction in hospital services 1. Respondent Name:

2. Age : (a) 20-30 (b) 30-40 (c)40-50 (d)50 and above

3. Gender: (a)Male (b)Female 4. Occupation: (a)Business (b)Employed professional (c)Home maker (d)Student

5. Are you aware of hospital? (a)Yes (b)No 6. If No, mention the hospital / clinic you have visited for treatment What made you to visit hospital? (a)Accessibility (b) Referral (c) Media (d) Hospital image

8. (A)How many days did you wait to get appointment? (a)Spot appointment (b)Two days (c)One week (d) More than a week (B)Do they follow appointmentTime / go by the appointment time?

(a)Yes (b)No

9. How well were you attended by the receptionist and patient coordinator at................. hospital. (a) Courteous (b) Helpful (c) Impatient (d) Not attentive

10. Tick the service you have received from .............hospital (a) Consultation (b) Counselling (c) Surgery (d) Post operative counseling

11. How would you rate the charges and cost of services of . hospital ? (a)High (b) Normal (c) Low (d) Don't Know 12. How would you rate the professionalism of the Doctors? (a)Excellent (b) Very good (c) Good (d) poor 13. How would you rate the professionalism of the Nursing staff? (a)Excellent (b) Very good (c) Good (d) poor

14. How would you rate the over all quality of...............hospital, considering all of your experience with them.? (a)Excellent (b) Very good (c) Good (d) poor

15. What did you dislike about the services?

16. How likely are you to recommend ..................hospital to a friend / relatives would you say chances are?

(a) Strong (b) Hesitant (c)Will not (d)Don't know 17.................. hospital in your opinion.