This questionnaire is designed for issue to patients to assess the service provided.

Questionnaire

You can help the Practice to improve its service.

  • The doctors and staff welcome your feedback
  • Please do not write your name on this survey
  • Please read and complete this survey and return to the surgery

Are you seeing

 
 
 
 

Name of Doctor/Practice Nurse (if applicable):

Access to a Doctor or Nurse

1. Speed at which the telephone was answered initially

 
 
 
 
 
 

2. Speed at which the telephone was answered if call transferred

 
 
 
 
 
 

3. Length of time you had to wait for an appointment

 
 
 
 
 
 

4. Convenience of day and time of your appointment

 
 
 
 
 
 

5. Seeing the Doctor of your choice

 
 
 
 
 
 

6. Length of time waiting to check in with Reception

 
 
 
 
 
 

7. Length of time waiting to see the Doctor or Nurse

 
 
 
 
 
 

8. Opportunity of speaking to a Doctor or Nurse on the telephone when necessary

 
 
 
 
 
 

9. Opportunity of obtaining a home visit when necessary

 
 
 
 
 
 

10. Level of satisfaction with the after hours service

 
 
 
 
 
 

Obtaining a repeat prescription - please indicate

 
 

11. Prescription ready on time

 
 
 
 
 
 

12. Prescription correctly issued

 
 
 
 
 
 

13. Handling of any queries

 
 
 
 
 
 

Obtaining test results

14. Were you told when to contact us for your results

 
 
 
 
 
 

15. Results available when you contacted us

 
 
 
 
 
 

16. Level of satisfaction with the amount of information provided

 
 
 
 
 
 

17. Level of satisfaction with the manner in which the result was given

 
 
 
 
 
 

About the staff

18. The information provided by the Reception staff

 
 
 
 
 
 

19. The helpfulness of the Reception staff

 
 
 
 
 
 

20. The information provided by other staff

 
 
 
 
 
 

21. The helpfulness of other staff

 
 
 
 
 
 

And finally

22. My overall satisfaction with this Practice

 
 
 
 
 
 

Any further comments

The following questions provide us only with general information about the range of people who have responded to this survey. It will not be used to identify you, and will remain confidential.

How old are you?

Are you?

 
 

How many years have you been attending this Practice?

Thank you very much for your time and assistance