Community Satisfaction Survey - Dr. Kariadi General Hospital

Your voice matters and helps us improve the quality of our care.

The Community Satisfaction Survey measures the quality of our services, captures your experience as a patient, and forms the basis for making care at Dr. Kariadi General Hospital better, faster and more responsive.

Respondent Data

Respondent Details

Please complete the patient details and the service unit. Age is filled in automatically once the date of birth is entered.

Medical Record Number

Full Name

Mobile Number

Gender

Date of Birth

Enter the date in day-month-year order.

Age ( years )

Filled in automatically from the date of birth.

Date Completed

Pre-filled with today's date.

Highest Education

Payer

Main Occupation

Service Unit

Type of Service

Service Rating

Your Opinion About the Public Service You Received

Choose a score from 1 to 4 for each service element.

Question 1

How well did the service requirements match the type of service you needed?

Question 2

How easy was the service procedure in this unit to follow?

Question 3

How would you rate the speed of the service you received?

Question 4

How reasonable was the cost or tariff of the service?

Question 5

How well did the service you received match the published service standard?

Question 6

How would you rate the competence and skill of the staff?

Question 7

How would you rate the courtesy and friendliness of the staff?

Question 8

How would you rate the quality of the facilities and infrastructure?

Question 9

How would you rate the way service user complaints are handled?

Would you recommend Dr. Kariadi General Hospital to your family, friends and relatives?

Please choose one answer.

Comments and Suggestions

* If you have any comments or suggestions, please mention the clinic or ward so we can follow up on the improvement.

Everything you share is kept confidential and used only to evaluate and improve the quality of care at Dr. Kariadi General Hospital.