CONSUMER SURVEY (PRIVATE MEDICAL PRACTITIONERS)

NAME: _________________________________________________________
AGE: _____________________
GENDER: Male Female
1. Do you or your family suffer from any ailment
Yes ( )
No ( )
2. How frequently you visit doctor (On the scale of 0 to 5, 0 being very
less and 5 being very often
0( ) 1( ) 2( )
3( ) 4( )
5( )
3. Does your family have any family doctor or you visit any random
doctor in town
1. Family doctor ( )
2. Random doctor ( )
3. Dont
know( )
4. Do you prefer government hospital or private medical practitioner
Government Hospital ( )
Private Medical
Practitioner ( )
5. Have you ever visited any government hospital
1. Yes ( )
2. No ( )
6. Do you find services provided by governmental hospital satisfactory
1. Yes ( )
2. No ( )
7. How do you choose private medical practitioner
One who has more experience ( )
One who is more famous ( )
One who is nearby ( )
8. Do you believe services provided private medical practitioner are
worth of money
Yes ( )
No ( )
9. Do you believe that private medical practitioner prescribe unwanted
and expensive medication
Yes ( )
No ( )
Cant say ( )

10.
Are you satisfied by the services provided my private medical
practitioner
Yes ( )
No ( )
11.
Do you believe medical facilities provided in our city are
satisfactory
Yes ( )
No ( )
Never noticed ( )
12.
Do you ever had case of medical negligence/ medical
malpractice
Yes ( )
No ( )
Cant disclose (
)
13.
Are you aware of any law related to medical negligence or
medical malpractice
Yes ( )
No ( )
14.
Have you heard of Consumer Protection Act, 1986 (COPRA)
Yes ( )
No ( )
15.
Do you believe services provided by private medical
practitioner are included in the COPRA
Yes ( )
No ( )
cant say ( )
16.
Have you ever approached consumer forum for medical
negligence or medical malpractice
Yes ( )
No ( )
17.
Do you hesitate in approaching consumer forum
Yes ( )
No ( )
Never thought
about it ( )
18.
On what ground you feel hesitant to approach consumer
forum
1. Disposal of case ( )
2.Expensive ( )
3. Noble Profession ( ) 4. Lack of knowledge ( )
19.
Do you find COPRA sufficient for medical negligence/ medical
malpractce
Yes ( )
No ( )
cant say ( )

20.
Whether inclusion of private practice will have some adverse
affect.
Yes ( )
No ( )
cant say ( )

For information regarding the consumer rights or to lodge any complain

call toll free at this number: 1800-11-4000
Or visit http://www.nationalconsumerhelpline.in/Telecom.aspx