Dear Patient,
Many thanks for agreeing to take this short diabetic survey enabling our practice to review your current diabetic care.
Please answer all of the questions and click 'Send Survey' when you are done.
Q1. Please indicate your age ?
Q2. Are you Male/Female ?
Q3. Please indicate the type of diabetes you have.
Q4. Where do you receive your diabetic review/care?
Q5. Please indicate how you consider your current diabetic care within this practice.
1 Poor - 5 Excellent
Q6. Has there been anything particularly good about your diabetes care at the Practice?
Q7 .
Could any area of your
care be improved?
Q8 . Please indicate any
diabetic information you would like to be made available to you?
Q9.
What outcomes would you
like to work towards?
Many thanks for your time in answering the questions on this survey.