8/10/2019 Nursing Homes_clinics India

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Sample Questionnaire Nursing Homes/Clinics

Id like to thank you for taking the time to speak with us. Currently we are carrying out a research project to understand trends in Blood

Analyzers among dierent hospitals, path las ! nursing homes in India. "e are inter#iewing $ey %pinion &eaders 'senior doctors( to

analyze their opinions and re)uirements regarding these products. *lease e assured that, that if you so wish, your identity will e kept

strictly con+dential. I would simply like to ask you a few )uestions on this suject. *lease feel free to tell me, if you are uncomfortale with

answering any of the )uestions.

Clinic-ursing ome -ame /////////////////////////////////////////////////////////////////////////////////////////

Address /////////////////////////////////////////////////////////////////////////////////////////

0espondent -ame /////////////////////////////////////////////////////////////////////////////////////////

1esignation /////////////////////////////////////////////////////////////////////////////////////////

*hone -o2 /////////////////////////////////////////////////////////////////////////////////////////

3oile -o2 /////////////////////////////////////////////////////////////////////////////////////////

4mail2 /////////////////////////////////////////////////////////////////////////////////////////

Patients Load Patient/day-o. of patients #isits per day-o. of patients prescried for any path tests-o. of the path tests performed within the clinicnursing home-o. of path tests referred to any path la

56. *lease tell me what kind of pathological tests facilities you ha#e at your nursing homeclinic7 'multiple options(

a#e own path la attached to the clinicnursing home 6

1oing lood or urine or stool or sputum tests manually 8

a#ing own lood analyzers and other de#ices 9

1o not ha#e any pathological tests facility :

0efer to the path las ;

Ask patients do at their own