Patient Satisfaction Questionnaire

Patient Satisfaction Questionnaire

All our staff need feedback on how they interact with patients. This form allows you to tell the medical staff how you felt about the way in which they dealt with your problem.

This is an anonymous survey so there is no need to identify yourself but you do need to tell us which doctor you saw so that we can feed the comments back to the correct person.

Did he/she introduce himself/herself to you?

How did you feel during your consultation?

Tense and hurried, very uncomfortable
At ease, not rushed, all my needs were respected

Did you feel that the doctor was attending to your problem?

Ignored what I was trying to say, kept interrupting to ask questions
Allowed me to say what I wanted. Helped me to explain

What do you think about the information given to you by the doctor?

Did not explain things well
Explained everything fully

How did you feel about asking questions if anything was not clear?

No chance to ask anything, not encouraged
Plenty of opportunity to ask and would have felt happy to ask

How would you feel if you were asked to see this doctor again?

Prefer to see someone else
Would ask to see this doctor

Overall how do you feel?

Very unhappy
Quite content