Patient Name
Company
Services / サービス
-Select-
Medical Checkup
Outpatient
Dental
Laboratorium
Radiology
Branch
-Select-
Jakarta - wisma keiai (main clinic)
Jakarta - Summitmas
Jakarta - BNI 46
Ejip - Cikarang
AXIA - Cikarang
Delta Mas - Cikarang
Bali
Surya Cipta - Karawang
KIIC - Karawang
Kyoai Medical Services Survey
How was your experience with our clinic?
1. How about tidiness and cleanliness?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
2. What about medical equipment?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
3. Are the signs for occupational health and safety signs appropriate and installed?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
Impact on medical personnel (doctors, nurses, officers, radiology, etc.)
1. Professionalism?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
2. hospitality and information provided related to the inspection carried out?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
Impact on non-medical personnel?
1. Professionalism?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
2. hospitality and information provided related to the inspection carried out?
Excellent
Good
Fair
Poor
We would appreciate your feedback / ご意見をお聞かせください。
Testimonial
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