Patient Satisfaction Survey Are you male or female Male Female What age are you?Under 1617-2425-3445-5455-6465-7475-84Over 84When did you join the practice? How often do you come to the practice? Regularly Occasionally Rarely Please select a rating in response to the followingThe practice opening hours OptionalPoorFairGoodVery GoodExcellentContacting the Surgery via Telephone: OptionalPoorFairGoodVery GoodExcellentHelpfulness of Practice receptionists: OptionalPoorFairGoodVery GoodExcellentAvailability of appointments with the doctor: OptionalPoorFairGoodVery GoodExcellentAbility to see a doctor of your choice: OptionalPoorFairGoodVery GoodExcellentThe clinical care received from the doctor: OptionalPoorFairGoodVery GoodExcellentThe approachability of the doctor: OptionalPoorFairGoodVery GoodExcellentThe overall satisfaction with the practice: OptionalPoorFairGoodVery GoodExcellentPlease comment on your rating if you wish: OptionalRespect shown for your privacy and confidentiality: OptionalPoorFairGoodVery GoodExcellentPlease comment on your rating if you wish: OptionalWould you recommend this practice? Yes Optional No Optional Please comment on your rating if you wish: OptionalPlease comment on two aspects of the practice that work well? OptionalPlease comment on two aspects of the practice that could be improved? Optional
