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QUESTIONAARIE
 
     
     
  Your Name    
  Nationality    
  Gender  Male  Female  
  Age < 20 Yrs.  20-30 Yrs.  31-40 Yrs.  41-50 Yrs. > 50 Yrs.   
 
  How did you know about Escorts Heart Institute and Research Center?
 
    Friends Family Advertisement Others  
 
  Which type of treatment are you seeking?
 
    Surgical   Non-Surgical      
 
  Which of these best describe the main purpose of you choosing Escorts Heart Institute and Research   Center?
 
    Facilities Price Location Quality of Service  
 
  How would you describe the staff at Escorts Heart Institute and Research Center?
 
 
   
Excellent Good Reasonable Poor  
 
   Politeness and courtesy
 
 
   Professionalism
 
 
   Interaction with patients
 
 
  Attaining customer expectation
 
 
   Helpfulness and friendliness
 
 
  How do you measure your satisfaction of medical treatment at Escorts Heart Institute and Research   Center?
 
    Very Satisfied Satisfied Unsatisfied Disappointed  
    How do you measure the overall services at Escorts Heart Institute and Research Center?
 
    Excellent Good Reasonable Poor