Scoring Reference

5 — Excellent: Proactively exceeded standard

4 — Good: Fully met standard

3 — Adequate: Partially met standard

2 — Poor: Significantly below standard

1 — Unacceptable: Standard completely absent

N/O — Not Observed during this visit

Facility Assessment Details

Fields marked * are required before you can proceed. Complete all details carefully — they will appear in your final report.

Facility Name *

Facility Type *

Visit Date *

Arrival Time *

Shopper Reference Code *

Shopper Profile Used *

Visit Scenario / Complaint Used *

Department(s) Visited *

Visit Number (in this cycle)

Before You Begin — Important Notice

You are about to conduct a confidential mystery shopping assessment on behalf of OPEX Africa. By proceeding, you confirm that you understand the nature of this engagement and agree to conduct this assessment with integrity, objectivity, and professionalism.

This assessment is strictly confidential. You must not disclose your role, purpose, or findings to any staff or person at the facility being assessed.
All observations must be honest, first-hand, and recorded as accurately as possible without exaggeration or bias.
Your submitted data will be used to generate reports shared with the facility's management and OPEX Africa clients — accuracy is critical.
You are operating under a pre-agreed scenario. Do not deviate from the assigned scenario unless instructed by the OPEX team.
Personal information collected during this visit (your shopper identity) is protected under OPEX Africa's data handling policy.
Any falsification of data, coaching of staff, or breach of confidentiality will result in immediate disqualification and may attract legal consequences.

For the full Terms & Conditions governing this engagement, please read the complete document here.

I have read and understood the above. I agree to the OPEX Mystery Shopping Terms & Conditions and confirm I will conduct this assessment with honesty and confidentiality.

Complete all required fields and agree to terms to continue.

General Observations & Shopper Reflection

Record your overall impressions, moments that stood out, and anything not captured in the scored criteria.

First Impression (arrive to first acknowledged)

Most Positive Moment of the Visit

Most Disappointing Moment

Staff Attitudes & General Culture

Physical Environment Overall

Any Patient Safety Concerns Observed

What Would Bring You Back as a Paying Patient?

Specific Staff Conduct Worth Flagging to OPEX (do NOT include names — describe role, department, approximate time)

Shopper Overall Experience Rating *

Shopper Signature / Initials *

Date Submitted *

Time Submitted *

Once submitted, your assessment is securely sent to the OPEX team. You do not need to print or export anything.

Facility Assessment Details

Mystery Shopping — Terms & Conditions