Patient Feedback Form


We recognise the integral part your comments play in improving our service and welcome your comments in the form below.

We understand that you are an individual and have needs that may be specific to you. We have done what we can to make your stay as comfortable as possible. This Patient Feedback Form is designed to assist us to determine whether the hospital is meeting the individual needs of patients and their families.

Your Name:
Room Number:
Date of Hospital Stay:
Did your stay at Hurstville Private meet your expectations:
Yes
Some reservations
No
If your stay with us was not quite what you had anticipated, what could we have done better?
We want to do our personal best to make your stay at Hurstville Private
fulfil your needs.
Please write your thoughts on what we did well for you.
Are there any members of our staff you would like to mention who were particularly helpful to you?
Image Verification: Please type the characters you see in the picture.
* Security Code: Security Code
   
Continuum Healthcare Group

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