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Pinuntahang Office/Department/Room #:

Kawani o Staff na nag bigay ng serbisyo:


Pakay o Sadya sa pag punta dito:

Natanggap ang serbisyong kailangan:

Mabilis at maagap ang serbisyo:

Ang kawani ay may sapat na kaalaman:

Ang kawani ay magalang at madaling lapitan:

Patas, tapat at sapat ang serbisyong ibinigay:

Malinis at maayos ang pasilidad:

Komento / Suhestiyon
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Data Privacy Notice

The personal information and data collected in this form is used for NICC's service improvement and to communicate with patients/companions, as needed. All information collected through this form are stored in a secure location in NICC, accessed by authorized staff. No data is shared with any external group. Data collected will be deleted one year from date of accomplishment.