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 How easy was it to access the service you needed at your most recent visit? Very Easy Optional Easy Optional Neither easy nor difficult Optional Difficult Optional very difficult Optional How satisfied were you with our range of services at your most recent visit? Very satisfied Optional Satisfied Optional Neither satisfied or dissatisfied Optional Dissatisfied Optional Very dissatisfied Optional Overall, how satisfied were you with our service at your most recent visit? Very satisfied Optional Satisfied Optional Neither satisfied or dissatisfied Dissatisfied Optional Very dissatisfied Optional 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: Optional
