Skip to content
Unit 12, 1st floor, 1 Melrose Boulevard
Melrose Arch, Johannesburg 2191
Home
About us
Our Hospitals
Abaqulusi Private Hospital
Medical Hospital of Lebowakgomo
RH Phodoclinic Private Hospital
RH Piet Retief Private Hospital
RH Rand Clinic
Contact us
Newsroom
Careers
Patient Survey
Patient Survey
Hospital
*
Select Hospital
Abaqulusi Private Hospital
Medical Hospital of Lebowakgomo (MEDLEB)
RH Phodiclinic
RH Piet Retief Private Hospital
RH Rand Hospital
Ward/Unit
*
Select Ward/Unit
CASUALTY
HICARE
ICU
MATERNITY
MEDICAL
NICU
PAEDS
POST NATAL
SURGICAL
Age
*
Gender
*
Male
Female
Other
Name & Surname
Nursing Care
How often did the nurses treat you with courtesy and respect?
*
0
1
2
3
4
How often did nurses listen carefully to you?
*
0
1
2
3
4
How often did nurses explain things in a way you could understand?
*
0
1
2
3
4
Doctor Care
How often did the doctors treat you with courtesy and respect?
*
0
1
2
3
4
How often did doctors listen carefully to you?
*
0
1
2
3
4
How often did doctors explain things in a way you could understand?
*
0
1
2
3
4
Response to request for assistance
Did you press the call bell?
*
Yes
No
After you pressed the call button, how often did you get help as soon as you wanted it?
*
0
1
2
3
4
Did you need help from nurses or other hospital staff in getting to the bathroom or in using a bedpan?
*
Yes
No
How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted?
*
0
1
2
3
4
Pain Control
Did you need medicine for the pain?
*
Yes
No
How often did the hospital staff do everything they could to help you with your pain?
*
0
1
2
3
4
How often was your pain well controlled?
*
0
1
2
3
4
Medication
Were you given any medicine that you had not taken before?
*
Yes
No
How often did the hospital staff tell you what the medication was for?
*
0
1
2
3
4
How often did the hospital staff describe possible side effects in a way you could understand?
*
0
1
2
3
4
Environment
How often was your room and bathroom kept clean?
*
0
1
2
3
4
How often was the area around your room quiet at night?
*
0
1
2
3
4
Going home
Did doctors, nurses or other hospital staff talk with you about whether you would have the help you needed when you left the hospital?
*
Yes
No
Did you get information in writing about what symptoms or health problems to look out for after you left the hospital?
*
Yes
No
Hospital
Please rate our hospital
*
0
1
2
3
4
5
6
7
8
9
10
Would you recommend this hospital to your friends and family?
*
0
1
2
3
4
Staff
During your hospital stay, was there one staff member who did a particularly good job or put in extra effort to care for you?
*
Yes
No
Please provide the staff member's name
How was this staff member was most helpful
*
Friendly, caring, helpful
Dedicated, attentive, responsive, available
Compassionate, provided comfort, reassurance, listening
Knowledgeable, provided extra information, kept patient company
Specially skilled in their job
Proactive arrangements made for patient
General information
How long were you in hospital
*
1-2 days
3-5 days
6-10 days
More than 10 days
Were you in hospital over a weekend?
Yes
No
How did you hear about us?
How did you hear about us?
Ambulance
Emergency
Flyer
Word of mouth
GP
Referal
Hospital Staff
Internet
Live in area
Media
Work here
Other staff
Passing
Previous Admission
School Tour
Signage
Specialist
Transfer
Visitor
Residential Suburb
Referring Doctor
Comments
What could we have done to make your stay with us better?
What did you like the most about your stay with us?
Additional comments
Contact number
Email Address
Submit
Please do not fill in this field.
Customize
Reject All
Accept All
Powered by
✖
►
Necessary Cookies
Always Active
Necessary cookies enable essential site features like secure log-ins and consent preference adjustments. They do not store personal data.
None
►
Functional Cookies
Remark
Functional cookies support features like content sharing on social media, collecting feedback, and enabling third-party tools.
None
►
Analytical Cookies
Remark
Analytical cookies track visitor interactions, providing insights on metrics like visitor count, bounce rate, and traffic sources.
None
►
Advertisement Cookies
Remark
Advertisement cookies deliver personalized ads based on your previous visits and analyze the effectiveness of ad campaigns.
None
►
Unclassified Cookies
Remark
Unclassified cookies are cookies that we are in the process of classifying, together with the providers of individual cookies.
None
