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It only takes 3-5 minutes to complete Upon completion, you’ll receive a special gift/voucher from DIAG 🎁
PART 1: PERSONAL INFORMATION
Full Name:
*
Phone Number:
*
Email (optional):
Branch:
*
How many times have you visited DIAG Medical Center?
*
PART 2: GENERAL SURVEY
How did you hear about DIAG Medical Center?
*
How did you hear about DIAG Medical Center?
Referred by friends or family
How did you hear about DIAG Medical Center?
Online ads (Facebook, TikTok, Instagram, etc.)
How did you hear about DIAG Medical Center?
Outdoor advertising (billboards, flyers, etc.)
How did you hear about DIAG Medical Center?
Recommended by a doctor/healthcare facility
How did you hear about DIAG Medical Center?
DIAG branch near my home
How did you hear about DIAG Medical Center?
Google search
How did you hear about DIAG Medical Center?
Other
How often do you visit DIAG Medical Center?
*
How often do you visit DIAG Medical Center?
Monthly
How often do you visit DIAG Medical Center?
Every 2-3 months
How often do you visit DIAG Medical Center?
Every 4-6 months
How often do you visit DIAG Medical Center?
Every 6 months
How often do you visit DIAG Medical Center?
Once a year
How often do you visit DIAG Medical Center?
Every 1-2 years
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
*
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Professional, friendly staff
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Doctor consultations available
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Clean environment
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Reasonable pricing
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Convenient location
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Promotions and discounts
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Home sample collection service
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Modern equipment and technology
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Fast and accurate results
What are the main reasons you chose DIAG Medical Center? (Select up to 3)
Other
List three things you are satisfied with at DIAG Medical Center:
*
List three things that didn’t meet your expectations
at DIAG Medical Center
?
*
If you could change three things, what would you suggest DIAG Medical Center improve:
*
PART 3: EXPERIENCE & FEEDBACK
Please rate your satisfaction with the following services at DIAG Medical Center:
1. Overall satisfaction with DIAG
*
1. Overall satisfaction with DIAG
Very Dissatisfied
1. Overall satisfaction with DIAG
Dissatisfied
1. Overall satisfaction with DIAG
Neutral
1. Overall satisfaction with DIAG
Satisfied
1. Overall satisfaction with DIAG
Very Satisfied
2. Security staff’s attitude
*
2. Security staff’s attitude
Very Dissatisfied
2. Security staff’s attitude
Dissatisfied
2. Security staff’s attitude
Neutral
2. Security staff’s attitude
Satisfied
2. Security staff’s attitude
Very Satisfied
3. Reception staff’s attitude
*
3. Reception staff’s attitude
Very Dissatisfied
3. Reception staff’s attitude
Dissatisfied
3. Reception staff’s attitude
Neutral
3. Reception staff’s attitude
Satisfied
3. Reception staff’s attitude
Very Satisfied
4. Nursing staff’s attitude
*
4. Nursing staff’s attitude
Very Dissatisfied
4. Nursing staff’s attitude
Dissatisfied
4. Nursing staff’s attitude
Neutral
4. Nursing staff’s attitude
Satisfied
4. Nursing staff’s attitude
Very Satisfied
5. Nursing staff’s technical skills
*
5. Nursing staff’s technical skills
Very Dissatisfied
5. Nursing staff’s technical skills
Dissatisfied
5. Nursing staff’s technical skills
Neutral
5. Nursing staff’s technical skills
Satisfied
5. Nursing staff’s technical skills
Very Satisfied
6. Doctor’s attitude
*
6. Doctor’s attitude
Very Dissatisfied
6. Doctor’s attitude
Dissatisfied
6. Doctor’s attitude
Neutral
6. Doctor’s attitude
Satisfied
6. Doctor’s attitude
Very Satisfied
7. Doctor’s expertise
*
7. Doctor’s expertise
Very Dissatisfied
7. Doctor’s expertise
Dissatisfied
7. Doctor’s expertise
Neutral
7. Doctor’s expertise
Satisfied
7. Doctor’s expertise
Very Satisfied
8. Waiting time for consultation/tests
*
8. Waiting time for consultation/tests
Very Dissatisfied
8. Waiting time for consultation/tests
Dissatisfied
8. Waiting time for consultation/tests
Neutral
8. Waiting time for consultation/tests
Satisfied
8. Waiting time for consultation/tests
Very Satisfied
9. Clinic environment
*
9. Clinic environment
Very Dissatisfied
9. Clinic environment
Dissatisfied
9. Clinic environment
Neutral
9. Clinic environment
Satisfied
9. Clinic environment
Very Satisfied
10. Services offered
*
10. Services offered
Very Dissatisfied
10. Services offered
Dissatisfied
10. Services offered
Neutral
10. Services offered
Satisfied
10. Services offered
Very Satisfied
11. Pricing
*
11. Pricing
Very Dissatisfied
11. Pricing
Dissatisfied
11. Pricing
Neutral
11. Pricing
Satisfied
11. Pricing
Very Satisfied
12. Test result delivery process
*
12. Test result delivery process
Very Dissatisfied
12. Test result delivery process
Dissatisfied
12. Test result delivery process
Neutral
12. Test result delivery process
Satisfied
12. Test result delivery process
Very Satisfied
How likely are you to recommend DIAG Medical Center to your friends and family?
*
How likely are you to recommend DIAG Medical Center to your friends and family?
Never recommend
How likely are you to recommend DIAG Medical Center to your friends and family?
Unlikely
How likely are you to recommend DIAG Medical Center to your friends and family?
Might recommend
How likely are you to recommend DIAG Medical Center to your friends and family?
Likely
How likely are you to recommend DIAG Medical Center to your friends and family?
Definitely recommend
Are there any services/packages/tests you would like DIAG Medical Center to offer?
*
What encourages you to return to DIAG Medical Center? (Select up to 3)
*
What encourages you to return to DIAG Medical Center? (Select up to 3)
Fast and accurate results
What encourages you to return to DIAG Medical Center? (Select up to 3)
Professional, friendly staff
What encourages you to return to DIAG Medical Center? (Select up to 3)
Doctor consultations available
What encourages you to return to DIAG Medical Center? (Select up to 3)
Clean environment
What encourages you to return to DIAG Medical Center? (Select up to 3)
Reasonable pricing
What encourages you to return to DIAG Medical Center? (Select up to 3)
Convenient location
What encourages you to return to DIAG Medical Center? (Select up to 3)
Promotions and discounts
What encourages you to return to DIAG Medical Center? (Select up to 3)
Home sample collection service
What encourages you to return to DIAG Medical Center? (Select up to 3)
Modern equipment and technology
What encourages you to return to DIAG Medical Center? (Select up to 3)
Other
Submit