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Questionnaire form

▼Information of respondent
Tell it about a visitor if all right.
Area to live
▼Impression when it was done the next House
How was the atmosphere of our House?
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How long did it take for waiting?
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About the medical examination of the doctor
▼About facilities facilities
General impression
In-hospital guidance indication
▼About our site
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Thank you for cooperation.
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Medical corporation Fukuji fortune surgery hospital
Wakaurahigashi, Wakayama-shi, Wakayama
TEL. 073-445-3101
FAX. 073-445-4660
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