quality | feedback

Patient feedback form

We welcome your feedback on your recent visit to a medical centre in our group. Your comments and suggestions will help us provide a better service.

Your name (*)
Invalid Input
Email address (*)
Invalid Input
Medical centre you visited: (*)
Invalid Input
Are you enrolled at this practice? (*)
Invalid Input
Date of your visit
Invalid Input

Making an appointment

Ease of reaching us by phone
Invalid Input
Helpfulness of booking staff
Invalid Input
Getting an appointment at the time you wanted
Invalid Input
Comments - booking experience
Invalid Input
Your arrival
Friendliness of reception staff
Invalid Input
Waiting time
Invalid Input
Comments - reception experience
Invalid Input
Your consultation
My consultation was with
Invalid Input
Respect & privacy in consultation
Invalid Input
Amount of time spent with you
Invalid Input
How well the dr/nurse communicated
Invalid Input
Your understanding of your health issue now
Invalid Input
Do you understand how you'll get test results?
Invalid Input
Comments - consultation
Invalid Input
General
Sensitivity of staff to your cultural values
Invalid Input
Reasons for choosing our centre
Invalid Input
Any other reasons?
Invalid Input
Would you recommend us to others?
Invalid Input
If no, please tell us why:
Invalid Input