RASED

Patient Experience Portal

Patient Complaint Form

We value your feedback. Please share your experience so we can improve our services.

Your feedback helps us improve quality of care

Full Name *

Contact (Phone/Email)

Complaint Category *

Staff behaviour

Delay / waiting time

Communication

Treatment quality

Facility / environment

Billing / administrative

Privacy / confidentiality

Other

Subject *

Description *

Department Involved

Date of Incident

Doctor Name

Nurse Name

Care Quality

Food Quality

Cleanliness

Preferred Resolution