Organisation Logo
English

Outpatients survey

Your feedback helps us to celebrate what's working well and identify where we need to improve. We would be grateful if you would take a moment to review the service you received whilst in our care.


1. Date of visit:

2. Overall, how would you rate your experience of our service?

3. Can you tell us why you gave that response?

4000 characters remaining
Next

4. Was it easy to find your way to the outpatients department?

5. Do you regard yourself as having a disability, impairment, or other condition that requires extra support or reasonable adjustments?

6. If yes, did the hospital staff do everything they could to provide this support or adjustment?

7. Did the clinician you saw listen to what you had to say?

8. Were you involved in decisions about your care and treatment?

9. Did you feel that your privacy and dignity were considered while you were in hospital?

10. Is there a member of staff who you would like to recommend and what they did to impress you?

4000 characters remaining
Next

Can we share your comment publicly (for example, on our website or printed material such as posters)?

11. Are you

12. Age:

13. What is your ethnicity?

14. If you answered 'self-describe' to the previous question, please specify:

4000 characters remaining
Next

Thank you

Thank you for taking the time to complete this survey