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Patient Satisfaction Survey 2016

1. Are you male or female (required)
 Male Female

2. What age are you? (required)
 Under 16 17-24 25-34 45-54 55-64 65-74 75-84 Over 84

3. When did you join the practice

4. How often do you come to the practice?
 Regularly Occasionally Rarely

5. How often have you seen a clinician in the last 3 months?
 Regularly Occasionally Rarely

Please select a rating in response to the following

6. The practice opening hours
 Poor Fair Good Very Good Excellent

7. Contacting the Surgery via Telephone:
 Poor Fair Good Very Good Excellent

8. Helpfulness of Practice receptionists:
 Poor Fair Good Very Good Excellent

9. Availability of appointments with the doctor:
 Poor Fair Good Very Good Excellent

10. Ability to see a doctor of your choice:
 Poor Fair Good Very Good Excellent

11. The clinical care received from the doctor:
 Poor Fair Good Very Good Excellent

12. The approachability of the doctor:
 Poor Fair Good Very Good Excellent

13. The overall satisfaction with the practice:
 Poor Fair Good Very Good Excellent

14. Please comment on your rating if you wish:

15. Respect shown for your privacy and confidentiality:
 Poor Fair Good Very Good Excellent

16. Please comment on your rating if you wish:

17. Would you recommend this practice?
 Yes No

18. Please comment on your rating if you wish:

19. Please comment on two aspects of the practice that work well?

20. Please comment on two aspects of the practice that could be improved?