Medical Practice Survey Form

The healthcare department of every country is comprised of a team of competent caregivers that provide extreme care in the hour of need. It helps patients to stabilize themselves in the worrisome environment of hospitals. Every patient desire to be healthy and get discharged as quickly as possible. It is because of the efforts of doctors and nursing staff that, patients regain their health in less time than anticipated.

What is a medical practice survey form?

A medical practice survey form refers to the feedback that healthcare staff receives from the patients and their representatives upon discharge. Patients throw light on all the good and bad things at the hospital and also acknowledge the efforts of the nursing staff which not only boast their morale but also help them in correcting their mistakes. Using survey forms, patients point out mistakes that should be corrected immediately for a better response.

It is generally believed that a doctor’s behavior treats diseases. If doctor listens carefully to their patients and priorities their values and beliefs, it cures patients without starting the treatment. It has a good effect on the overall health of the patient. Medical service survey forms are question-based documents and gather useful information for the better working of their healthcare facility.

Components of the form

Survey forms are devised by the administration of healthcare facilities to gain information about their medical services from their patients. These strategies have been in use for a long period of time because of their positive impact.


Mostly, survey forms are questionnaires with multiple choices to help people in choosing the most appropriate answer. The information they seek includes,

  • Patient information: name, age, weight, date of birth, and hospital registration number are all filled in the document to verify the authenticity of the patient.
  • Hospital information: date of admittance, date of discharge, ailment, and services received, in charge doctors and nursing staff are also included in the document.
  • Questionnaire: mostly, the following information is collected through questions,
  • Admittance: was the process of hospital admission smooth or did u face difficulty? Was the staff at reception helpful? Did u find assistance in filling out forms?
  • Diagnosis: were u able to get in touch with the concerned doctor? Did the doctor make any diagnosis?
  • Communication: did you communicate with the doctor about the diagnosis? Was the doctor able to help you understand the entire situation?
  • Diagnostic test: were you able to locate the laboratory for testing? Was the lab staff helpful? Was the entire procedure smooth?
  • Treatment: was your treatment started immediately after the results came in? Did you notice any change in your health condition after the start of treatment? Was the nursing staff on time for medication and food?
  • Medications: is the hospital pharmacy equipped with all the medications that are required? Is the staff helpful? Are they charging according to the actual pricing of the medicine?
  • Discharge: have you filled out your discharge papers? Did your doctor ask for a follow-up? Are you satisfied with the services provided here? Would you refer the medical services of this hospital to your relatives and friends?
Medical practice survey form

Simi Karton

Dr. Simi Karton currently resides in Los Angeles with her husband. This website is a voluntary work of Dr. Karton to provide people with useful health-related information with a straightforward approach.

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