Sample Health Evaluation

Sample health evaluation makes up the process of health assessment in health institutions. It is conducted by experts to inquire and gain information about all aspects of health of the population as well as their level of satisfaction with the present health services.

Sample Health Evaluation

Name of the company: South Hall Hospital

Contact details: 6, Jessore Avenue

Cherry Hill, USA-8787889

Phone number: 48557688                                          Date of evaluation: 8th June, 2011

Purpose of the evaluation: To know the persisting health related problems and devise suitable medical assistance for their prevention and eradication.

Hospital license number: 456GH

Please mark the right option for each of the questions given below to carry out a thorough health evaluation:

1. Do you receive pamphlets/booklets carrying information about AIDS/ Cancer/ Leprosy from the hospital grounds?

  1. Yes always
  2. Sometimes
  3. Never

2. How many tools and machines used for surgery/treatment are upgraded?

a. More than ten

b. Less than ten

3. When was the last time you suffered from a serious illness?

  1. 2 years ago
  2. This year

4. Do you and your family wash hands every time before touching food?

a. Most of the time

b. Rarely

c. Occasionally

5. Which of the following habits do you possess?

a. Alcohol

b. Smoking

c. Drugs

6. What kind of communication pattern do you share with your doctor?


7. What is the first thing that you do when your child falls sick suddenly?

a. I run to the medical store

b. I consult family members and relatives

c. I call the doctor

Download Sample Health Evaluation

Category: Health Evaluation

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