Cherry Medical Practice

Appointment System 2

Date

Are you male or female?

MALE

FEMALE

Are you happy with the current appointment system?

YES

NO

If NO please state why?

Do you always keep your appointments?

YES

NO

NOT ALL THE TIME

What do you think could improve the appointment system?

If we had an evening clinic - would you attend?

YES

NO

Would you be happy to have telephone consutations?

YES

NO

If you answered NO, please could you tell us why?

When you make an appointment to see the Dr, are the appointments you make ABSOLUTELY neccessary?

YES

NO

I DONT KNOW

What do you do if you need a Dr after 6.30pm?

Optional - you can give your name and contact details if you wish so we can contact you about obtaining your views and comments