Please Wait!
You will be redirected in few seconds.
×
Please Wait!
You will be redirected in 10 seconds.
How was your interaction with the doctor today?
Tap here to give feedback
Please fill this feedback form based on your most recent interaction with the doctor and from the perspective of the patient.
You're filling this form as...
Yourself
Your child
Your partner or spouse
A relative or friend
Which of the following reasons best describes the reason for your visit today? (please select all that apply)
To seek the doctor's advice
To discuss an ongoing problem
To get treatment & prescription
To discuss a one-off issue
For routine check up
For other reasons
Based on your experience today, how good was your doctor on each of the following parameters?
Pathetic
Poor
Satisfactory
Good
Great
Option
Pathetic
Poor
Satisfactory
Good
Great
Being polite
Pathetic
Poor
Satisfactory
Good
Great
Making you feel at ease
Pathetic
Poor
Satisfactory
Good
Great
Listening to you
Pathetic
Poor
Satisfactory
Good
Great
Assessing your condition
Pathetic
Poor
Satisfactory
Good
Great
Explaining your condition
Pathetic
Poor
Satisfactory
Good
Great
Discussing your treatment
Pathetic
Poor
Satisfactory
Good
Great
Based on your experience today, how likely are you to recommend this doctor to your friends and family?
Not at all likely
0
Not at all likely
1
2
3
4
5
6
7
8
9
10
Extremely likely
Extremely likely
Would you like to share any comments and suggestions about your experience today?
Done
▶
Replay
Thank you for your feedback.
Cancel
Choose a Country Code
No code found as per your search
Choose Location
No location found as per your search