Manor Park Surgery

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Patient Survey

Name:

Email:

Address:

Postcode:

Telephone:

Appointments

If you need to be seen urgently we will try our best to give you an appointment on the same day. This appointment might not be with your regular doctor. If you need a non-urgent appointment we will try our best to give you an appointment within the month of your call.

Considering this appointment system, please tell us how much you agree with the following statements:

 
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
If I need an urgent appointment I am usually seen the same day
If I need a non-urgent appointment I am usually seen within one month
I am happy with the current appointment system

Opening Times

We appreciate that many patients need flexible opening times. Our current opening times are:

Mon
8am - 6pm
Tues
8am - 6pm
Wed
8am - 6pm
Thurs
8am - 6pm
Fri
8am - 6pm

Considering our opening times, please tell us how much you agree with the following statements:

 
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
The practice is open at times when I can attend an appointment
I am happy with the current opening times

Our Surgery

We want to make your visit to the surgery as pleasant as possible. Please tell us how much you agree with the following statements:

 
Strongly disagree
Disagree
Neither agree
nor disagree
Agree
Strongly agree
The practice is easy to get to
The staff are friendly and approachable
The practice is clean and tidy
Overall I think the practice is welcoming

Clinical Care

Providing excellent clinical care is our priority. Please tell us how much you agree with the following statements:

Clinical staff are Doctors, Nurses and Healthcare Assistants
Strongly disagree
Disagree
Neither agree
nor disagree
Agree
Strongly
agree
I feel listened to by the clinical staff
The clinical staff treat me with dignity and respect
The clinical staff communicate their message clearly and effectively
I am confident in the treatment I receive from the clinical staff
I am happy with the clinical care I receive

Equality monitoring

By filling in this equality monitoring section you will help us ensure that we get feedback from all the different communities in our area. Filling in this section is optional. Any information is kept in strict confidence.

Are you?

Male Female

 

Hetrosexual/Straight
Lesbian/gay woman
Gay man
Bisexual

 

Under 16

55 - 64 yrs

17 - 24 yrs

65 - 74 yrs

25 - 34 yrs

75 - 84 yrs

35 - 44 yrs

Over 84

45 - 54 yrs

 

 

 

White British

White Irish

Gypsy or Irish traveller

Mixed White & Black Caribbean

Mixed White & Black African

Mixed White and Asian
Asian/Asian British Indian
Asian/Asian British Pakistani
Asian/Asian British Bangladeshi
Black/Black British Caribbean
Black/Black British African
Chinese
Arab
Other

 

Are You Disabled?
Yes No

 

How often do you visit our surgery?

Regularly
Occasionally
Very rarely

Comments

 

 


Thank you for taking the time to fill in this survey. We will be feeding back the results of this survey in the next few months.

 

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