Appointment:
No   Yes

Test:

MRD No.:

Patient Name:

Patient Email:

Patient Contact:

Please Tick Your Overall Satisfaction Level:

Experience Criteria About	Excellent	Good	Average	Poor
Ease Of Contacting Centre Through Telephone
Service Rendered By Reception
Co-operation And Guiding By Front Office Staff
Waiting Experience For Your Turn
Radiological Service
Co-operation Of Staff During Visit
Hygiene Cleanliness And Maintenance
General Impression About The Centre

Comments & Suggestions

Would You Recommend ARM Health to a friend or colleague?	Yes	No
Timely Delivery & Accuracy Of Reports:	Yes	No
The Feedback has been Filled By:	Patient	Attendent

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