1.Ease of contacting the practice by telephone
2. Level of satisfaction with day and time of your appointment (face to face or telepohne consult)
3. Getting care for illness or injury as required
4. Ease of ordering repeat prescriptions
5. Information on on-line services ie ordering prescriptions and appointments
6. Ease of getting referral to consultant when required
7. Level of satisfaction with waiting room/premises
8. Your phone calls answered promptly
9. The courtesy of the person who took your call
10. The information provided by Reception Team
11. Overall satisfaction with this visit to the doctor/nurse
12. The doctor's/nurse's explanation of health problems or treatments to me were
13. The extent to which I felt assured by the doctor/nurse was
14. My confidence in doctor's/nurse's ability was
15. The opportunity the doctor/nurse gave me to express my concerns or fears was:
16. The respect shown to me by the doctor/nurse was:
17. The amount of time given to me for this visit was:
18. The doctor’s/nurse’s consideration of my personal situation in deciding a treatment or advising me was:
19. Level of satisfaction with appointment date given for consultant referral (within a reasonable waiting time)
20. If you have had an appointment at Worthing Hospital in the last 6 months, please rate your satisfaction with the service that was provided
21. Information on Out of Hours services
22. Level of satisfaction with the Out of Hours service received
23. The opportunity for making compliments or complaints to this practice about its service and quality of care
24. Your overall satisfaction with the Practice is:
25. Recommendation to friends and family
26. Any further comments about how the Practice could improve their service or quality of care
Any further comments about other services, i.e. Out of Hours, secondary care services or other NHS services
27. Are you male or female?
28. How old are you?
29. What is your ethnic group? Please choose ONE section from A to E and tick the appropriate box to indicate your cultural background
30. Which of the following best describes you?
31. How many years have you been attending this practice? …
32. Name of Nurse/GP you have seen recently