A hospital assessment template is a layout that is directed towards the patients and helps to assess the facilities offered at the hospital. This template is significant because through this feedback the services in the hospital can be improved. Any such document can be used by any hospital to analyse and evaluate opinions of people about the facilities offered by the hospital. These templates are pre written with all those entries which are common to any such document. The customisable nature of it allows users to add personal information and hence use it for their hospitals separately.
There are many examples and samples of assessment templates available on this website for your use.
You can Download the Free Hospital Assessment Template form, customize it according to your needs and Print. Hospital Assessment Template is either in MS Word, Excel or in PDF.
Sample Hospital Assessment Template
Hospital Assessment Template
Download Hospital Assessment Template
Name of the patient_________________________________
Date –/–/—- [dd/mm/yyyy]
Age_______________________________________ [Mention the age of the patient]
Duration of your stay at the hospital ________________________________
Give a brief description of the purpose of visit in the hospital
_________________________________________________________________
How would you rate the services of the hospital as a whole from 0-10? ________
Were you satisfied with the doctor’s treatment?
1) Yes
2) No
How did you find the ambience of the hospital?
1) Excellent
2) Good
3) Satisfactory
4) Bad
On the cleanliness meter how much would you rate the hospital? [Rate from 0-10 out of 10]
__________
Were the nurses efficient?
1) Yes
2) No
Do you have complaints? If yes, then do let us know.___________________________________________________________
Do give us suggestions in ways that we can serve you better. _______________________________________________________________________________________________________________________________________________________________________________________________________________
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