Q1 Are you aware that we have regular meetings of the Patient Forum to discuss the services that we provide as well as the wider health care provision in the local area?
Q2 If you would like to be a member of the Patient Forum when would be the best time for you to attend meetings? (please tick all that apply)
Q3 Are you aware that in addition to the Patient Forum meetings we also have a 'virtual' group for patients who cannot attend meetings but are willing to receive information and questionnaires and to share their views via email?
Q4 Do you have any suggestions for increasing the role of patients in making decisions about healthcare services locally?
Q5 How easy is it to get through to someone at Alresford Surgery on the phone?
Q6 How easy is it to speak to a doctor or nurse on the phone at Alresford Surgery?
Q7 How do you normally book your appointments at Alresford Surgery? (please X all boxes that apply)
Q8 Which of the following methods would you prefer to use to book appointments at Alresford Surgery? (please X all boxes that apply)
Q9 Do you subscribe to our email newsletter?
Q10 Do you read our newsletter published in local newletters and parish magazines?
Q11 Do you use our website as a source of information about our services and general healthcare advice?
Q12 Is Alresford Surgery currently open at times that are convenient to you?
Q13 Which of the following additional opening hours would make it easier for you to see or speak to someone? Please note that any increase in evening and/or weekend cover will reduce the appointment availablity during normal business hours (please X all boxes that apply)
Q14 Do you receive text message reminders of your appointments?
Q15 Do you have any comments to make about our premises or suggestions for any improvements we can make?
Q42 Are you ?
Q43 How old are you?
Q44 Do you have a long-standing health condition?
Q45 What is your ethnic group?
Q46 Which of the following best describes you?
Finally, please add any other comments you would like to make about your GP practice:
GPAQ-R © 2013 is reproduced with the kind permission of the University of Manchester & University of Cambridge. GPAQ incorporates the Primary Care Assessment Survey (PCAS); with permission from Dr Dana Gelb Safran creator of PCAS. www.gpaq.info