Patient Satisfaction Survey

Patient Satisfaction Survey

Thank you for taking the time to complete and return this survey. We would be grateful for your comments, both good and bad. We rely on our client’s feedback to improve our service and help us to plan for the future. Please be assured that your responses will be treated as strictly confidential.

Name(Required)
Date of birth(Required)
YesNoN/A
1. Was the practitioner polite and considerate?
2. Did the practitioner listen to what you had to say?
3. Did the practitioner give you enough opportunity to ask questions?
4. Did the practitioner answer all your questions?
5. Did the practitioner explain things in a way you could understand?
6. Are you involved as much as you want to be in the decisions about your care and treatment?
7. Did you have confidence in the practitioner?
8. Did the practitioner respect your views?
9. If the practitioner examined you, did he or she ask your permission?
10. If the practitioner examined you, did he or she respect your privacy and dignity?
11. By the end of the consultation did you feel better able to understand and/or manage your condition and your care?