Feedback about your experience

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We are very keen to continuously improve the service we provide to our clients. Your views about this are very important to us and will be treated in the strictest confidence. We will not ask your name or other information that can identify you. Please answer the following questions as honestly as you can.

Which borough did you access the service in: *

Please state the month you had your first appointment with the service:

Overall, how satisfied are you with the service you received? *

Not at all satisfied

Satisfied

Very satisfied

Was it easy to contact Breathe? *

Yes

Were you offered a range of options of support to choose from? E.g. support by telephone, face to face appointments, Nicotine Replacement Therapy (patches, gum etc.) sent by post. *

Yes

Which support did you choose? *

A few sessions of face to face appointments, followed by telephone support

Telephone support, with the option of receiving Nicotine Replacement Therapy in the post

Several face to face appointments with the advisor over a period longer than a month

Other:

Did you find the service flexible and convenient to access? *

Yes

Unsure

Were you offered a choice of medication? *

Yes

Was it helpful having your carbon monoxide (CO) reading done? *

Yes

I did not have a CO reading taken

Did you stop smoking? *

Yes

Would you recommend our service to your family/friends? *

Yes

Unsure

If you started smoking again would you return to the service for help to stop? *

Yes

Unsure

How did you hear about Breathe Stop Smoking Service? *

Breathe website or social media (Facebook & Twitter)

Marketing materials (postcards, leaflets & posters)

Outreach team (community event / Breathe van)

Family or friend

GP / Pharmacy / Other healthcare professional

Used service before

Other:

Do you have any further comments you would like to add?

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms