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Booking Appointments
Please answer these questions with reference to booking this / your last appointment at Witham Health Centre.
1. Was this an urgent appointment (i.e. booked on the day you were seen)?
2. With regards to your appointment.....
a) I was happy with the choice of appointments I was offered
b) The appointment I made was at a time convenient time for me
Seeing the Doctor or Nurse
Please complete the question for the doctor, nurse or both depending on who you saw at your last appointment.
3. If you saw a DOCTOR
a) I was satisfied about seeing the doctor of my choice
b) After arriving at the surgery, the wait to see the doctor was reasonable
c) I was happy with the medical care I received
d) Adequate time was given to my problem
e) I received clear explanations or written information about my problem
4. If you saw a NURSE
a) After arriving at the surgery, the wait to see the nurse was reasonable
b) I was happy with the medical care I received
c) Adequate time was given to my problem
d) I received clear explanations or written information about my problem
Test Results
5. Have you received any test results recently?
If yes, who gave you the test results?
6. If you received TEST RESULTS, were you happy with the way the results were given to you
Collecting Medication
If you are on any repeat medication (i.e. a regular prescription that you collect every month) please answer the questions below. Please tick as many boxes as apply to you.
7. Are you aware of this method of ordering repeat medication?
a) Fax
b) Post
c) Box on Reception Desk
8. Do you use this method of ordering repeat medication?
a) Fax
b) Post
c) Box on Reception Desk
9. Any additional comments you would like to make
About You
This section is optional. You do not have to give details if you do not wish to do so.
Gender:
Current Age:
Ethnic Background:
If other, please state
How often do you visit the practice
Thank you for completing this questionnaire