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A. Appointments

Q1. How do you normally book your appointments to see a doctor or nurse at the Surgery? Please tick the answers that apply

 
 
 

Q2. Which of the following methods would you prefer to use to book an appointment at the Surgery? Please tick the answers that apply

 
 
 
 
 

Q3. Which of the following methods would you prefer to use to order a repeat subscription? Please tick the answers that apply

 
 
 
 

B. Getting through on the phone

Q1. In the past 6 months how easy have you found the following?
Getting through on the phone

 
 
 
 
 

Speaking to a doctor on the phone

 
 
 
 
 

Speaking to a nurse on the phone

 
 
 
 
 

Obtaining test results by phone

 
 
 
 
 

C. Seeing a doctor

Q1. In the past 6 months have you tried to see a doctor fairly quickly? By fairly quickly we mean on the same day or in the next two weekdays that the Health Centre was open. Please tick one of the following

 
 
 

Q2. In circumstances where you need to see a doctor fairly quickly, would you be satisfied to speak to a doctor over the telephone in the morning between 8am and 9am? Please tick one of the following

 
 

D. Arriving for your appointment

Q1. How easy do you find getting into the building through our front doors at the surgery? Please tick one of the following

 
 
 
 

Q2. How helpful do you find the receptionists at the Surgery? Please tick one of the following

 
 
 

E. Opening Hours

Q1. How satisfied are you with the opening hours at the surgery?

 
 
 
 
 
 

Q2. As far as you know is the surgery open
Before 9am?

 
 
 
 

At lunchtime?

 
 
 
 

After 6.30pm?

 
 
 
 

F. Communication

Q1. Which of the following do you use to find out information about the surgery and the services it offers? Please tick one of the following

 
 
 
 

Q2. Is there a particular Support Group that you would like to see set up at your surgery? Please tick one of the following

 
 
 

Other (please name)

Q3. This practice has a very active Patient Group who works alongside the practice team aiming to meet the needs of its patients. Would you like to join our patient group? Please tick one of the following

 
 
 
 
 

If you wish to be contacted via email, please leave your email address below:

G. Some questions about you

The following questions will help us to see how experiences vary between different groups of the population. We will keep your answers completely confidential. Please tick the boxes that apply

Q1. Are you male or female?

 
 

Q2. How old are you?

 
 
 
 
 
 
 
 
 

Q3. What is your ethnic group? (Choose one section from A to E below, and then select the appropriate option to indicate your ethnic group)
A. White

 
 
 

B. Mixed

 
 
 
 

C. Asian or Asia British

 
 
 
 

D. Black or Black British

 
 
 

E. Chinese or other ethnic group

 
 

OVERALL

Q1. Did you feel you were treated with respect and dignity while you were in the surgery?

 
 
 

Q2. How would you rate the care you received?

 
 
 
 

Thank You for Filling out Our Patient Survey Today

This survey is now closed