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Other city :
Will you be describing private or public medical institutions in the city?
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Public
Private
How satisfied are you with the skill and competency of the local medical staff?
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
Speed in completing examinations and reports?
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
Do hospitals have equipment for modern diagnosis and treatment?
Very Modern Equipment
Quite Modern Equipment
Neutral
Somewhat Old Equipment
Very Old Equipment
Not Sure
How satisfied are you with the accuracy and completeness in filling out reports?
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
Friendliness and courtesy of the staff?
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
How satisfied are you with the responsiveness (waitings) in medical institutions?
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
Convenience of location for you
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
Cost to you
Very Satisfied
Somewhat Satisfied
Neutral
Somewhat Dissatisfied
Very Dissatisfied
Not Sure
What kind of medical insurance coverage do you have?
---Please Select---
National
Employer-Sponsored
Private
None