GUM Clinic - Health Adviser Client Survey

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Thank you for taking the time to complete this short survey based on your recent experience at the clinic. This survey will be used for the purposes of service development for the Health Adviser team. Please answer all questions as honestly as you can. Your responses will be anonymous and you will not be required to provide any personal details.

1. 1. What was the reason for your most recent appointment at the clinic?

Please select only one from the following options

I had symptoms
I wanted a peace of mind check-up, I had no symptoms
A sexual partner advised me to attend
I was referred by my GP or other testing service (e.g. Rainbow, Brook)
I received a call from the clinic to advise me to attend
Other (please specify):

2. Before your check up, how would you have answered the following:
Please select one answer for each statement ranging from Strongly Disagree to Strongly Agree.

	Strongly Disagree	Disagree	Not sure	Agree	Strongly Agree	N/A
I had a good understanding of and sexual health	I had a good understanding of and sexual health Strongly Disagree	I had a good understanding of and sexual health Disagree	I had a good understanding of and sexual health Not sure	I had a good understanding of and sexual health Agree	I had a good understanding of and sexual health Strongly Agree	I had a good understanding of and sexual health N/A
I did not know how to protect myself from infections	I did not know how to protect myself from infections Strongly Disagree	I did not know how to protect myself from infections Disagree	I did not know how to protect myself from infections Not sure	I did not know how to protect myself from infections Agree	I did not know how to protect myself from infections Strongly Agree	I did not know how to protect myself from infections N/A
I use a condom for all sex	I use a condom for all sex Strongly Disagree	I use a condom for all sex Disagree	I use a condom for all sex Not sure	I use a condom for all sex Agree	I use a condom for all sex Strongly Agree	I use a condom for all sex N/A
I get a STI check up regularly (e.g. every six months)	I get a STI check up regularly (e.g. every six months) Strongly Disagree	I get a STI check up regularly (e.g. every six months) Disagree	I get a STI check up regularly (e.g. every six months) Not sure	I get a STI check up regularly (e.g. every six months) Agree	I get a STI check up regularly (e.g. every six months) Strongly Agree	I get a STI check up regularly (e.g. every six months) N/A
All STIs come with symptoms	All STIs come with symptoms Strongly Disagree	All STIs come with symptoms Disagree	All STIs come with symptoms Not sure	All STIs come with symptoms Agree	All STIs come with symptoms Strongly Agree	All STIs come with symptoms N/A
I never use condoms	I never use condoms Strongly Disagree	I never use condoms Disagree	I never use condoms Not sure	I never use condoms Agree	I never use condoms Strongly Agree	I never use condoms N/A
I would be anxious about going for STI check ups	I would be anxious about going for STI check ups Strongly Disagree	I would be anxious about going for STI check ups Disagree	I would be anxious about going for STI check ups Not sure	I would be anxious about going for STI check ups Agree	I would be anxious about going for STI check ups Strongly Agree	I would be anxious about going for STI check ups N/A
My sexual partners would tell me if they had a STI	My sexual partners would tell me if they had a STI Strongly Disagree	My sexual partners would tell me if they had a STI Disagree	My sexual partners would tell me if they had a STI Not sure	My sexual partners would tell me if they had a STI Agree	My sexual partners would tell me if they had a STI Strongly Agree	My sexual partners would tell me if they had a STI N/A
I use condoms for Oral Sex	I use condoms for Oral Sex Strongly Disagree	I use condoms for Oral Sex Disagree	I use condoms for Oral Sex Not sure	I use condoms for Oral Sex Agree	I use condoms for Oral Sex Strongly Agree	I use condoms for Oral Sex N/A

3. When accessing the service you may have spoken to a Health Adviser. What do you think the role of a Health Adviser is?

You can select more than one option from the following

4. What contact did you have with a Health Adviser?

Please select from the following options. More than one option may apply.

I saw the Health Adviser in the clinic on the day of my check up
I spoke to the Health Adviser on the phone- they contacted me with my results, advice or information
I did not see the Health Adviser in the clinic when I attended for a check-up.
If you did not see a Health Adviser at your appointment, please specify why below:

Comments:

5. Thinking about your meeting with the Health Adviser (either in person or on the phone), how comfortable did you feel when discussing your sexual health at the time?

Please select one from the following options.

I felt really embarrassed. I didn’t feel comfortable talking to the Health Adviser.
At the start I felt uncomfortable but after a while it was easy to talk to the Health Adviser
I felt comfortable. I have no problems talking about sex and sexual health

Other (Please Specify)

6. If you think it can be uncomfortable to talk about sex and sexual health with the Health Adviser, please tell us what you think would help to make this easier?

Please provide your answer below:

GUM Clinic - Health Adviser Client Survey

1. 1. What was the reason for your most recent appointment at the clinic? Please select only one from the following options

2. Before your check up, how would you have answered the following:Please select one answer for each statement ranging from Strongly Disagree to Strongly Agree.

3. When accessing the service you may have spoken to a Health Adviser. What do you think the role of a Health Adviser is? You can select more than one option from the following

4. What contact did you have with a Health Adviser? Please select from the following options. More than one option may apply.

5. Thinking about your meeting with the Health Adviser (either in person or on the phone), how comfortable did you feel when discussing your sexual health at the time?Please select one from the following options.