Psymplicity Patient Feedback Form
Introduction

We have designed this form to help ensure that the services we provide offer you safe, effective and compassionate care.

It is very important to us that our patients can feedback thoughts on how we can improve our services.

All information provided will be treated in the strictness confidence, please see our privacy policy on our website for more details.
Name (Optional)
Your answer
Date of Appointment
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Name of Dr or Psychotherapist seen
Your answer
Care and Treatment
Have you felt well supported by the customer care team? Add a rating out of 5 with 5 being Very Well Supported.
Have you felt involved in decisions made about your condition, care and treatment? Add a rating out of 5 with 5 being very involved.
Did you feel that you were treated with respect and dignity? Add a rating out of 5 with 5 being very confident.
Do you feel that clear and helpful information has been provided to you about your condition, treatment and care? Add a rating out of 5 with 5 being very clear and confident.
Clinical Staff
Do you have confidence and trust in the staff treating and caring for you? Add a rating out of 5 with 5 being full confidence.
Comments
Your answer
Have you felt well looked after by the staff treating or caring for you?
Comments
Your answer
Overall View
If a friend or relative of yours needed treatment, would you be happy to recommend Psymplicity Healthcare based on the standard of care you have received yourself?
Comments
Your answer
If you have any further feedback, please include these below.
Your answer
How would you rate your appointment with Psymplicity today? Add a rating out of 5 with 5 being excellent.
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