Patient Questionnaire

As part of our ongoing quality assessment and patient satisfaction, we utilise a patient feedback questionnaire,
Please fill our the details as accurately as possible below –

Q1. Your experience with reception staff at your last visit

Please rate each statement
Were professional in dealing with you
Considered your needs when making an appointment
Were courteous and polite
Do you have any comments you would like to make about your experience with reception staff at your last visit?

Q2. Your experience of the interpersonal skills of the clinician at your last visit Please rate each statement

Please rate each statement
Understood your personal circumstances
Had enough time to talk about the things that were important for you
Let you talk about alternative therapies you were using
Do you have any comments you would like to make about your experience with clinical staff at your last visit?

Q3. Your experience of the way the practitioner communicated with you at your last visit

Please rate each statement
The clinician had enough time to listen to what you had to say
Involved you in decisions
Do you have any comments you would like to make about the way clinicians communicated with you at your last visit?

Q4. If you could change one thing about the practice, what would you change?

Please write your ideas below

Q5. General Information

Have you been to another general practice in the last year?
How do you identify?
What is your age?
Was this visit for yourself or someone you are caring for?