SOS (UCT) - Referral partner feedback
Dear Colleague
You have been referring some of your patient to Sports Orthopaedic Service at Groote Schuur Hospital.
This questionnaire is to improve the referral to our clinic.
Please could you answer the following questions so that we can improve our referral pathways.
About you
What is your last name *
Your answer
Name of your clinic or hospital *
Your answer
Area (location) of your practice or hospital *
Your answer
Your email address *
Your answer
Your profession *
Estimated percentage of patients without health care insurance in your practice *
Your feedback to us
Are you happy with our overall service *
Not Happy at all
Very happy
Did you find the referral system we are using accessible and easy to use? *
Not at all
very much
How long did it take you to get feedback regarding the appointment of the patient? *
How important is our clinical feedback to you once we have assessed or operated the patient you referred *
Not important at all
Very important
Do you get feedback from us regarding the patients you are referring? *
Do you resume treating the patients after we have assessed or operated them? *
Would you be interested in workshops regarding the pathology you are referring to us? *
Not at all
very much
What do you like about our service *
Your answer
What do you think we should improve *
Your answer
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