Patient Satisfaction Survey

1. Cripps Health Centre Patient Satisfaction Survey

We always aim to provide services that result in a good patient experience. We would be grateful if you could kindly fill in this survey regarding your visit to the practice today and treatment you received. The information received will be used to inform future service developments and to maintain a high level of patient satisfaction in the future.

1. Please enter your unique reference number provided by the practice.

2. Where did you receive your treatment? *

3. If not registered at The University of Nottingham Health Service which practice are you currently registered at?

4. Which service did you receive? *

5. How would you rate the service you received? *

	Very satisfactory	Satisfactory	Neither satisfactory or dissatisfactory	Dissatisfactory	Very dissatisfactory
Ability to make an appointment	Ability to make an appointment Very satisfactory	Ability to make an appointment Satisfactory	Ability to make an appointment Neither satisfactory or dissatisfactory	Ability to make an appointment Dissatisfactory	Ability to make an appointment Very dissatisfactory
Information received before appointment (e.g. criteria to receive treatment, what the treatment involves))	Information received before appointment (e.g. criteria to receive treatment, what the treatment involves)) Very satisfactory	Information received before appointment (e.g. criteria to receive treatment, what the treatment involves)) Satisfactory	Information received before appointment (e.g. criteria to receive treatment, what the treatment involves)) Neither satisfactory or dissatisfactory	Information received before appointment (e.g. criteria to receive treatment, what the treatment involves)) Dissatisfactory	Information received before appointment (e.g. criteria to receive treatment, what the treatment involves)) Very dissatisfactory
Information received after appointment (e.g. how results will be fed back, aftercare)	Information received after appointment (e.g. how results will be fed back, aftercare) Very satisfactory	Information received after appointment (e.g. how results will be fed back, aftercare) Satisfactory	Information received after appointment (e.g. how results will be fed back, aftercare) Neither satisfactory or dissatisfactory	Information received after appointment (e.g. how results will be fed back, aftercare) Dissatisfactory	Information received after appointment (e.g. how results will be fed back, aftercare) Very dissatisfactory
Signposting	Signposting Very satisfactory	Signposting Satisfactory	Signposting Neither satisfactory or dissatisfactory	Signposting Dissatisfactory	Signposting Very dissatisfactory
Treatment received	Treatment received Very satisfactory	Treatment received Satisfactory	Treatment received Neither satisfactory or dissatisfactory	Treatment received Dissatisfactory	Treatment received Very dissatisfactory
Treatment Room	Treatment Room Very satisfactory	Treatment Room Satisfactory	Treatment Room Neither satisfactory or dissatisfactory	Treatment Room Dissatisfactory	Treatment Room Very dissatisfactory
Parking facilities	Parking facilities Very satisfactory	Parking facilities Satisfactory	Parking facilities Neither satisfactory or dissatisfactory	Parking facilities Dissatisfactory	Parking facilities Very dissatisfactory
Accessibility (taking into consideration any potential barriers such as language and for people with hearing, visual and physical impairments)	Accessibility (taking into consideration any potential barriers such as language and for people with hearing, visual and physical impairments) Very satisfactory	Accessibility (taking into consideration any potential barriers such as language and for people with hearing, visual and physical impairments) Satisfactory	Accessibility (taking into consideration any potential barriers such as language and for people with hearing, visual and physical impairments) Neither satisfactory or dissatisfactory	Accessibility (taking into consideration any potential barriers such as language and for people with hearing, visual and physical impairments) Dissatisfactory	Accessibility (taking into consideration any potential barriers such as language and for people with hearing, visual and physical impairments) Very dissatisfactory
Dignity and privacy	Dignity and privacy Very satisfactory	Dignity and privacy Satisfactory	Dignity and privacy Neither satisfactory or dissatisfactory	Dignity and privacy Dissatisfactory	Dignity and privacy Very dissatisfactory
OVERALL EXPERIENCE	OVERALL EXPERIENCE Very satisfactory	OVERALL EXPERIENCE Satisfactory	OVERALL EXPERIENCE Neither satisfactory or dissatisfactory	OVERALL EXPERIENCE Dissatisfactory	OVERALL EXPERIENCE Very dissatisfactory

6. Which of words or phrases below describe how you felt about your visit: (tick all that apply)
The attitude of staff:

7. Which of words or phrases below describe how you felt about your visit: (tick all that apply)
The environment:

8. Which of words or phrases below describe how you felt about your visit: (tick all that apply)
The appointment itself:

9. Which of words or phrases below describe how you felt about your visit: (tick all that apply)
Your feelings:

10. Do you have any other comments about the service you received?

11. How do you think this service could be improved?