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Hermitage Medical Clinic Comment Card

Having you stay with us at the Hermitage Medical Clinic was our pleasure. Please take the time to help us make this a comfortable, professional and efficient hospital by completing this online comment card.

Alternatively, you can download the comment card in PDF format by clicking here

Patient Information

Comment Card

Comment Card

First Name *
Last Name *
Email *
Address
Telephone no
Room no
Date of visit / MM / DD YYYY
1. Was your admission procedure dealt with efficiently and professionally? * Poor Fair Good Very Good
2. What was your level of satisfaction with updates on your medical procedures and progress? * Poor Fair Good Very Good
3. What was your level of satisfaction with updates on your medical procedures and progress? * Poor Fair Good Very Good
4. How would you rate the information given to you about your discharge and out-patient follow up? * Poor Fair Good Very Good
5. How would you rate our catering standards and service? * Poor Fair Good Very Good
6. How would you rate food choices? * Poor Fair Good Very Good
7. How would you rate the cleanliness on the ward? * Poor Fair Good Very Good
8. Was your dignity maintained and privacy respected? Please rate same. * Poor Fair Good Very Good
9. How would you rate the attitude and helpfulness of staff? * Poor Fair Good Very Good
10. How would you rate access to amenities? (i.e. shop, t.v) * Poor Fair Good Very Good
11. Did any particular staff member's performance stand out? Do you remember their name?
Comments
12. Have you any suggestions that might enhance our service to you and your family?
13. Any aspects of your accommodation that needs improvement?

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