Adelaide Street Family Practice

Patient Survey: March 2012

This survey is now closed

How Are We Doing?

Please take a few minutes to fill out this survey on the timeliness and quality of the service you receive whenever you contact the practice. Adelaide Street Family practice & The Harris Medical Centre welcomes your feedback and your answers will be kept confidential. Thank you for your participation.

General Patient Information

First of all, please tell us which practice you visit most regularly?

Adelaide Street

The Harris Medical Centre

Q1. In general, what is the quality of your health?

Excellent

Good

Some issues

Poor

Q2. How would you rate our concern for your privacy?

Excellent

Good

Adequate

Needs improvement

Poor

N/A

Q3. How often have you visited the practice within the past year?

None

Once

2-5 visits

More than 6 visits

Booking Appointments

Q4. Thinking about the last appointment you booked, do you feel you were given an appointment?

Immediately

Within a reasonable amount of time

Not as quickly as I wanted

Far too long

N/A

Q5. How did you book your last appointment?

By phone (go to Q6)

At reception (go to Q7)

Online (go to Q7)

With doctor/nurse at previous appointment (go to Q7)

Can't remember (go to Q7)

Not booked one recently (go to Q7)

Q6. How easy was it to make an appointment by telephone?

Very easy

Quite easy

Easy

Not very easy

Difficult

Very difficult

Q7. Thinking about the last time you had contact with our reception team; did you find them courteous and helpful?

Very

Quite

Fairly

Not

Definitely Not

Day of Your Appointment

Q8. When you arrived for your appointment, how long after your appointment time did you have to wait to be seen?

On time or early

1 to 5 minutes

5 to 20 minutes

20 to 40 minutes

Over 40 minutes

Q9. What was your impression of the waiting area?

Excellent

Good

Adequate

Not adequate

Awful

The Nursing Staff – The last time you saw a nurse…

Q10. How would you rate the competence of the nurse who helped you?

Outstanding

Good

Adequate

Needs improvement

Poor

N/A

Q11. How would you rate the concern that the nurse showed for your problem?

Outstanding

Good

Adequate

Needs improvement

Poor

N/A

The doctor – The last time you saw a doctor…

Q12. Were you able to see the doctor of your choice?

Yes

No (See below)

N/A

If you ticked 'No', please state which doctor you wanted to see below

Q13. Did you feel that your doctor spent an adequate amount of time with you?

Yes

No

N/A

Q14. Mark the boxes that applied to the doctor you saw (You can choose more than one):

Attentive

Concerned

Friendly

Distracted

Rushed

Inconsiderate

Q15. How would you rate the competence of your doctor?

Outstanding

Good

Adequate

Needs improvement

Poor

N/A

Q16. Did you feel that your doctor’s examination was thorough?

Yes

No

N/A

Q17. Please rate the clarity of the doctor’s explanation of your condition and treatment options:

Outstanding

Good

Adequate

Needs improvement

Poor

N/A

Q18. How well did your doctor include you in healthcare decisions?

Outstanding

Good

Adequate

Needs improvement

Poor

N/A

Q19. Were your questions answered to your satisfaction?

Yes

No

N/A

Improvements

Q20. Compared to 12 months ago, would you say the practice facilities & services have?

Greatly improved

Improved slightly

Stayed the same

Got worse

Got significantly worse

N/A

Q21. Would you recommend this practice and its staff to your family and friends?

Yes

No

N/A

Additional Feedback

Please list any areas in which our service could be improved.

Please share any additional comments.

Personal Information

Providing the following information is optional.

First Name:

Last Name:

Date of birth:

Would you like someone to contact you regarding your responses on this survey?

Yes

No

N/A

Thank you for taking the time to fill out our survey. We rely on your feedback to help us improve our services.

This survey is now closed