PATIENT SURVEY

In order to provide the highest standard of care could you please complete the survey below? This survey is anonymous and staff will not be able to identify your responses.

Please answer all of the questions and click 'Send Survey' when you are done.

Do you have any long standing illness?

 
 

Do you have a disability?

 
 

Sex

 
 

Age

Ethnic Origin

Ability to get through to practice by telephone

 
 
 
 
 

How helpful were the Receptionists today

 
 
 
 
 

Opportunity of speaking to a doctor/nurse on the phone when necessary.

 
 
 
 
 

Quality of care by doctor/Nurse during today’s consultation

 
 
 
 
 

Information provided by the Practice about its services. (e.g. Repeat Prescriptions, test results, cost of private letters etc.)

 
 
 
 
 

Practice is offering online Services for making appointment, requesting repeats and Electronic Prescription Service. Please speak to receptionist for further information.

Finally would you recommend this Surgery to your friends and family?

 
 

Practice wants to trail once a week walk-in service. Would this be helpful?

 
 

ADDITIONAL COMMENTS

Many thanks for your time in answering the questions on this survey