Q1. Firstly, please tell us the name of your usual doctor
Q2. In the past 12 months, how many times have you seen a doctor from this practice?
Q3. How do you normally book appointments to see a doctor or nurse? Please tick all that apply
Q4. If you need to see a doctor urgently, can you normally get seen on the same day?
Q5. Have you ever used the self check-in?
Q6. How useful did you find the self check-in?
7 How do you rate the hours the practice is open for appointments?
Q8. Thinking of times you have phoned the practice, how do you rate the following?
h) Ability to get through to the practice on the phone?
b) How you are treated by the receptionist?
c) Ability to arrange to speak to a doctor on the phone when you have a question or need advice?
Q9. How important is it to you to see the doctor of your choice?
10 Which is the most important to you? Please tick only one
Q11. Thinking about when you consult your doctor, how do you rate the following:
h) How thoroughly the doctor ask about your symptoms and how you are feeling
b) How well the doctor listens to what you had to say?
c) How well the doctor puts you at your ease during your physical examination?
d) How much the doctor involves you in decisions about your care?
e) How well the doctor explains your problems or any treatment that your need?
f) The amount of time your doctor spends with you?
g) The doctor’s patience with your questions or worries?
h) The doctor’s caring and concern for you?
12 Have you seen a nurse from your practice in the last 12 months?
13 Thinking about the nurse(s) you have seen, how do you rate the following?:
a) How well they listen to what you say?
b) The quality of the care they provide?
c) How well they explain your health problems or any treatment that you need?
Q14. How pleasant do you find the surgery building?
Finally, it will help us to understand your answers if you could tell us a little about yourself:
Q15. Are you:
Q16. How old are you?
17 Which ethnic group do you belong to?
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THANK YOU AGAIN FOR TAKING THE TIME TO COMPLETE THIS QUESTIONNAIRE