Feedback Form

Thank you for staying with us at Hibiscus Private Hospital. We trust that your stay was most comfortable, pleasant and that all your expectations were not only met, but also exceeded.

Your comments and suggestions assist us in ensuring that we provide the highest standards at all times.

If you have not already done so, we would be very grateful if you would take the the time to give us your impressions of Hibiscus Private Hospital. Please note that the three lines marked with * are required for processing.

Your full name:* Date admitted:* Date discharged:* Patient # (if available): Your email address (optional):   1. Reception Excellent Good Acceptable Unacceptable 1.1  Admission 1.2  Reception staff courteous 1.3  Reception staff discreet 1.4  Reception area clean and tidy 1.5  Financial implications of admittance adequately handled If NOT excellent, please tell us why.   2.  Switchboard Operator Excellent Good Acceptable Unacceptable 2.1  Efficiency and attitude of our switchboard operator (Ext. 9) 2.2  Was your call answered punctually? If NOT excellent, please tell us why.   3.  Fedics Cleaning Services Excellent Good Acceptable Unacceptable 3.1  Cleanliness and tidiness of ward 3.2  Cleanliness and tidiness of bathroom 3.3  Adequate disposal of waste from bathroom 3.4  Adequate disposal of waste from your bedside 3.5  Efficiency, attitude and attire of the cleaning staff 3.6  Overall impression of Cleaning Services If NOT excellent, please tell us why.   4.  Fedics Catering Services  -  All Meals Excellent Good Acceptable Unacceptable 4.1  Food presentation 4.2  Tray quality and presentation 4.3  Food taste 4.4  Food temperature 4.5  Overall impression of Catering Services 4.6  Menu choice If NOT excellent, please tell us why.   5.  Hospital Maintenance Excellent Good Acceptable Unacceptable 5.1  State of repair of ward (i.e., lighting, TV, aircon, plumbing, fixtures, etc.) 5.2  Maintenance efficiency and attitude If NOT excellent, please tell us why.   6.  Nursing Service Excellent Good Acceptable Unacceptable 6.1  Competence and professionalism of nursing staff 6.2  Warmth and understanding of nursing staff 6.3  Daily change of linen 6.4  Readiness on arrival 6.5  Timeous response for assistance to nurse call system 6.6  Was your stay comfortable? 6.7  Effective and timeous response for pain control 6.8  Assistance to toilets 6.9  Assistance with bathing If NOT excellent, please tell us why.   7.  Ward Hostess Excellent Good Acceptable Unacceptable 7.1  Standard of service 7.2  Order taken efficiently and courteously 7.3  Speed of delivery 7.4  Completeness of order 7.5  Removal of tray 7.6  Efficiency, attitude and attire of the ward hostess If NOT excellent, please tell us why.   8.  Overall Impression Excellent Good Acceptable Unacceptable 8.1  How would you rate your stay at Hibiscus Private Hospital? 8.2  Based on your overall experience, would you recommend our Hospital to someone else? Yes No If NOT excellent, please tell us why.   General Comments or Suggestions   Hibiscus Private Hospital Superstar Please write in the blank(s) below the name and department of any HPH staff member(s) who went the ‘extra mile’ and left a lasting impression on you. Staff member’s name Department / job title     Thank you for taking the time to complete this form!