1) In the last 12 months, how many times did you visit the surgery?
2) How satisfied are you with the appointment system?
3) Which of the following methods would you prefer to use to book an appointment?
4) Are you aware that we have online services?
a) Have you used any of the following online services? Please tick the one that applies.
b) If you have, how easy did you find them?
5) Are you aware of other services provided by the Practice?
6) If yes, please list the services that you are aware of that the Practice provides
7) How would you rate the clinician at Listening to you?
a) How would you rate the clinician at Asking about your symptoms?
b) How would you rate the clinican at Giving you enough time?
c) How would you rate the clinican at Treating your with care concern?
d) How would you rate your clinican at Explaining tests and treatment?
e) How would you rate the clinican at Involving you in decisions about your care?
8) How often are you able to see or speak to the clinical of your choice?
9) How would you rate the receptionists in Courtesy?
a) How would you rate the receptionists at being Helpful?
b) How would you rate the receptionists at Treating you with respect?
c) How would you rate the receptionists in Listening to you?
d) How would you rate the receptinists in Answering any of your questions?
10) How would you rate the overall performance of the surgery 0-10?
11) Please make any comments or suggestions on how our Practice can improve the services that we provide to our patients.
12) To help us analyse your answers, please tell us a few things about yourself.10) Are you Male or Female?
13) What is your age?
14) What is your ethnicity?
15) Which of the following best describes you?
Many thanks for taking the time to complete our survey.
Your Practice Team
If you are interested in becoming a member of the patient representation group (PRG) to express you views and opinions, then please complete a registration form that is available from the receptionist.