ANNEXURE - II

Questionnaire for
SERVQUAL Model

- 286 -
 Questionnaire for SERVOUAL Model
Please evaluate ________ hospital on a scale of 1-7 on the following parameters.

TANGIBLES
1. Good Parking 1 2 3 4 5 6 7 r Parking

2. Modem Equipment 1 2 3 4 5 6 7 Medical Equipment

3. Clean premises 1 2 3 4 5 6 7 y Premises

4. Confusing Signboards 1 2 3 4 5 6 7 in Signboards

5. Pleasant Interiors 1 2 3 4 5 6 7 leasant Interiors

6. Smartly dressed employees 1 2 3 4 5 6 7 3by employees

7. Ease of Access (location) 1 2 3 4 5 6 7 icult to access

8. Spacious rooms 1 2 3 4 5 6 7 nped rooms

9. Large no. of specialities 1 2 3 4 5 6 7 specialities

10. High availability of drags 1 2 3 4 5 6 7 r availability

11. Good canteen facilities 1 2 3 4 5 6 7 r Canteen facilities

RELIABILITY

12. Error free records 1 2 3 4 5 6 7 t*records

13. Timely attention 1 2 3 4 5 6 7 much delay

14. Correct diagnosis 1 2 3 4 5 6 7 mg diagnosis

RESPONSIVENESS

15. Proactive Staff 1 2 3 4 5 6 7 nterested Staff

., Promptness (in responding to
1 2 4 5 6 7 c o f promptness
calls)
17. Proper updates to patients 1 2 D 4 5 6 7 r updates

18. Thigh on Timeliness 1 2 3 4 5 6 7 r timeliness

- 287 -
 ASSURANCE

19 Good reputation 1 2 3 4 5 6 7 r reputation

20. Professionalism of staff 7 c o f professionalism

21. Competence of doctors [ 1 [ [ 2 || 3 |P 4 || 5 [| 6 || 7 [mpetence o f doctors

22. Reassuring Behaviour | 1 11 2 11 3 11 4 11 5 11 6 || 7 |reassuring behaviour

EMPATHY

23. Good individual care 2 3 4 5 6 7 r individual care

„ r
24. Good facilities for disabled 2 3 4 5 6 7 i

25. Low initial waiting time i 2 3 4 5 6 7 l initial waiting time

26 Affordable Rates i 2 3 4 5 6 7 :s too high.

x=x=x=x=x=x=x=x=x

- 288 -