Consumer Survey Questionnaire
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CONSUMER S URVEY (PRIVATE MEDICAL PRACTITIONERS) NAME: _____________________________________________________ ____ AGE: _____________________ GENDER: Male Female 1. Do you or your family suffer from any ailment Yes ( ) No ( ) 2. How frequently you visit doctor (On the scale of 0 to 5, 0 being very less and 5 being very often 0( ) 1( ) 2( ) 3( ) 4( ) 5( ) 3. Does your family have any family doctor or you visit any random doctor in town 1. Family doctor ( ) 2. Random doctor ( ) 3. Don’t know( ) 4. Do you prefer government hospital or private medical practitioner Government Hospital ( ) Private Medical Practitioner ( ) 5. Have you ever visited any government hospital 1. Yes ( ) 2. No ( ) 6. Do you find services provided by governmental hospital satisfactory 1. Yes ( ) 2. No ( ) 7. How do you choose private medical practitioner
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Transcript of Consumer Survey Questionnaire
CONSUMER S URVEY (PRIVATE MEDICAL PRACTITIONERS)
NAME: _________________________________________________________AGE: _____________________GENDER: Male Female
1. Do you or your family suffer from any ailmentYes ( ) No ( )
2. How frequently you visit doctor (On the scale of 0 to 5, 0 being very less and 5 being very often0( ) 1( ) 2( ) 3( ) 4( ) 5( )
3. Does your family have any family doctor or you visit any random doctor in town1. Family doctor ( ) 2. Random doctor ( ) 3. Don’t know( )
4. Do you prefer government hospital or private medical practitionerGovernment Hospital ( ) Private Medical Practitioner ( )
5. Have you ever visited any government hospital 1. Yes ( ) 2. No ( )
6. Do you find services provided by governmental hospital satisfactory1. Yes ( ) 2. No ( )
7. How do you choose private medical practitionerOne who has more experience ( )One who is more famous ( )One who is nearby ( )
8. Do you believe services provided private medical practitioner are worth of moneyYes ( ) No ( )
9. Do you believe that private medical practitioner prescribe unwanted and expensive medicationYes ( ) No ( ) Can’t say ( )
10. Are you satisfied by the services provided my private medical practitionerYes ( ) No ( )
11. Do you believe medical facilities provided in our city are satisfactory Yes ( ) No ( ) Never noticed ( )
12. Do you ever had case of medical negligence/ medical malpracticeYes ( ) No ( ) Cant disclose ( )
13. Are you aware of any law related to medical negligence or medical malpracticeYes ( ) No ( )
14. Have you heard of Consumer Protection Act, 1986 (COPRA)
Yes ( ) No ( )
15. Do you believe services provided by private medical practitioner are included in the COPRAYes ( ) No ( ) can’t say ( )
16. Have you ever approached consumer forum for medical negligence or medical malpracticeYes ( ) No ( )
17. Do you hesitate in approaching consumer forumYes ( ) No ( ) Never thought about it ( )
18. On what ground you feel hesitant to approach consumer forum1. Disposal of case ( ) 2.Expensive ( )3. Noble Profession ( ) 4. Lack of knowledge ( )
19. Do you find COPRA sufficient for medical negligence/ medical malpractceYes ( ) No ( ) can’t say ( )
20. Whether inclusion of private practice will have some adverse affect. Yes ( ) No ( ) can’t say ( )
