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Patient Satisfaction Survey
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How likely are you to recommend our service / team to friends and family if they needed similar care or treatment?
*
1. Extremely Likely
2. Likely
3. Neither Likely nor unlikely
4. Unlikely
5. Extremely unlikely
6. Don't know
Please could you tell us the main reason for the answer you have chosen?
Your answer
We would like you to answer some further questions about your experience.
Q1. Were you treated with dignity and respect?
Yes, always
Yes, sometimes
No
Clear selection
Q2. Were you involved as much as you wanted to be in your care and treatment?
Yes, always
Yes, sometimes
No
No, I did not need to be involved
Clear selection
Q3. Did you receive timely information about your care and treatment?
Yes, always
Yes, sometimes
No
No, I did not need any information about my treatment
Clear selection
Q4. Were you treated with kindness and compassion by the staff looking after you?
Yes, always
Yes, sometimes
No
Clear selection
Q5. Did everyone who was directly involved in your care introduce themselves?
Yes, always
Yes, sometimes
No
Clear selection
We would like to ask you some questions about yourself
Are you male or female?
Male
Female
Clear selection
What age are you?
0-7
8-11
12-15
16-24
25-34
35-44
45-54
55-64
65-74
75+
Clear selection
Do you consider yourself to have a disability?
Yes
No
Clear selection
What is your ethnic group?
White
Asian or Asian British
Mixed Ethnic Group
Black or Black British
Other:
Clear selection
What is your nationality?
British
Polish
Russian
Chinese
Latvian
Lithuanian
Other:
Clear selection
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