Dr. Soliman Fakeeh Hospital

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For Patients > Patient Relation Dept
Upon admission, you will be visited by the Patients Relation representatives who will orient you with the DSFH "Patients' rights and responsibilities statement".

During your stay, they will visit you daily to ensure that your needs are being met. They will provide you with a service questionnaire to solicit your opinion on the services provided. Also through the Patient Relation Representative you may voice your complaints, compliments and/or suggestions about all aspects of service or care that you or your visitors have encountered.
Patient Relations Department
Select the Form for

Thank you for taking time to provide us with your feedback about our services.
Personal Information:
Date :
Building: Building 1
Building 2
In - Patient - Room No:
Out - Patient - Clinic:
Respondent Name:
Relation to patient:
Patient Name
Patient Medical Record No:
Telephone No:  
Mobile:
Home:
Work:
Fax No:
Email:
Subject (In detail) :
Date & Time of incident
Place
Involved person:
1
2
3
Witness (If present)
1
2
Nature of subject: