INTERVIEW SCHEDULE

Name: Occupation: Age: Residence: Sex:

1. Why did you come to Safdarjung Hospital? 2. How did you come to the hospital? 3. Were you accompanied by any family members/relatives? 4. Is this your first visit or have you come before? 5. How much time did you have to spend at the registration counter? 6. Are your medical bills taken care of by any agency/government like cghs, ndmc, employee insurance etc? 7. Were you asked for your bpl/apl/ration/ndmc/cghs or any other similar paperwork at the registration? 8. Were you able to find the doctor you are here to see easily? 9. For how much time did you have to wait before you were attended to by the doctor? 10. Was there a proper waiting area near you? 11. Was there an eating area near you? 12. How would you grade the level of hygiene in the hospital? 13. Do you think that the toilet and drinking water facilities were adequate? 14. Did you need a trolley/wheelchair? 15. If yes, were you able to find it easily? 16. Were the patients seen on the basis of a queue or out of turn also?

17. Do you feel that the doctor spent enough time in your examination? 18. How was the attitude of the doctor towards you? 19. Did the doctor listen to your problem patiently? 20. Were you interrupted frequently during your examination? 21. Were you able to understand the doctors diagnosis easily? 22. Were you able to understand the directions given by the doctor easily? 23. How was the attitude of the paramedical staff towards you? 24. Were you able to get the prescribed medicines/test within the hospital? 25. If no, is the place of reference where you will get the medicines/tests far for you? 26. Were you satisfied with the services that you received in the hospital? 27. If you have been to a private doctor earlier, how was your experience here as compared to the private hospital/clinic where you went? 28. According to you what more needs to be done? 29. Will you come again?