New Court Surgery

Patient Survey 2012-2013

Q1 Are you:

Male

Female

Q2. Are you aged:

16-19

20-29

30-39

40-49

50-59

60-69

70-79

80+

Q3. How often do you use the surgery?

Weekly

Monthly

6-10 times per year

3-5 times per year

1-2 times per year

Occasionally - less than once per year

Q4. When contacting the surgery do you: tick all that apply

Use the telephone

Visit in person

Use the surgery website

Q5. When you contact the surgery is it for: tick all that apply

An appointment with the Doctor

An appointment with the Nurse

Ordering and collecting repeat prescriptions

Requesting a home visit

Asking for a telephone consult/advice

other

Q5a. If you answered other to the above question please specify

Q6. When telephoning the surgery are you generally happy with the service that the receptionists provide

Yes

No

Q6a. If you answered No please specify the problem and advise how the service could be improved.

Q7. When visiting the surgery are you generally happy with the service that the receptionists provide?

Yes

No

Q7a if you answered No to the above question plese specify the problem and how the service may be improved.

Q8. Do you have access to a computer?

Yes

No

Q8a. If you answered yes to the above question, do you use the Surgery Website?

Yes

No

Q8b. Is there anything that could be added to the Webiste that would be useful to you?

Q8c. Is there anything you would change on the Website?

Q9. If the surgery were to produce a regular newsletter would you prefer:

To read a copy whilst at the surgery

To read a copy on the surgery website using your computer

Q10. If a newsletter were produced what would you like it to contain? tick all that apply.

The surgery contact numbers and web address

Emergency out of hours service and how it works

Upcoming events: Flu vaccination clinic dates

Clinics run by the nursing staff

Updates on the work being carried out at our new premises

Surgery times and types of services

Information on which doctors work on which days

Q10a. Can you think of any other topics for the newsletter?