Patient FFT Community Neuro Rehab Team North 325994

1. We would like you to think about your experience of this service
Overall, how was your experience of our service? *

2. Thinking about the service we provide, please can you tell us why you gave your answer?

3. Please tell us about anything that we could have done better

4. Please put a tick in one of the boxes for each of the questions below

	Strongly agree	Agree	Neither agree nor disagree	Disagree	Strongly disagree
Were you treated with dignity and respect?	Were you treated with dignity and respect? Strongly agree	Were you treated with dignity and respect? Agree	Were you treated with dignity and respect? Neither agree nor disagree	Were you treated with dignity and respect? Disagree	Were you treated with dignity and respect? Strongly disagree
Were you involved as much as you wanted to be in your care and treatment?	Were you involved as much as you wanted to be in your care and treatment? Strongly agree	Were you involved as much as you wanted to be in your care and treatment? Agree	Were you involved as much as you wanted to be in your care and treatment? Neither agree nor disagree	Were you involved as much as you wanted to be in your care and treatment? Disagree	Were you involved as much as you wanted to be in your care and treatment? Strongly disagree
Did you receive timely information about your care and treatment?	Did you receive timely information about your care and treatment? Strongly agree	Did you receive timely information about your care and treatment? Agree	Did you receive timely information about your care and treatment? Neither agree nor disagree	Did you receive timely information about your care and treatment? Disagree	Did you receive timely information about your care and treatment? Strongly disagree
Were you treated with kindness and compassion by the staff looking after you?	Were you treated with kindness and compassion by the staff looking after you? Strongly agree	Were you treated with kindness and compassion by the staff looking after you? Agree	Were you treated with kindness and compassion by the staff looking after you? Neither agree nor disagree	Were you treated with kindness and compassion by the staff looking after you? Disagree	Were you treated with kindness and compassion by the staff looking after you? Strongly disagree

5. If you needed to leave a voicemail, did we return your call within 1 working day?

Yes
No
N/A
Other (please specify):

6. If you needed to contact our service by telephone, were you happy with the way we handled your call?

Yes
No
N/A

Please explain why did you give this answer

7. What age are you?

8. Are you male or female

Male
Female
Prefer not to say
I think of myself as

I think of myself as:

9. The person completing this form

The Patient
A carer
A family member

10. Do you consider yourself to have a physical or mental health condition or disability?

Yes
No

11. What is your ethnic group?

12. 10. Are you happy for your feedback to be published anonymously?

Yes
No

13. Was this survey completed via *

Website Link
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