Patient Feedback Survey

her Medical Patient experience questionnaire 2022

Thank you for agreeing to complete our questionnaire about your visit to our practice today.

The questionnaire is designed to gather feedback from patients on their experience with our practice so that we can improve our patient care. This feedback will help us better understand what our patients want.The questionnaire is voluntary, confidential and anonymous. Your answers cannot be linked to you in any way. Your care will not be affected by completing the questionnaire or if you change your mind and decide not to complete it.

To complete the questionnaire, please answer every question by placing a tick in the box that most closely matches your answer. We would like you to answer every question.

• If the question does not apply to you, there is a ‘Not applicable’ (N/A) option.

• If you do not know the answer, you can use the ‘Don’t know’ option.

Your opinion is important to us. There are no right or wrong answers; we simply want you to rate your experience of the practice. The information will assist the doctors, nurses and other staff to help improve patient care. If you have any questions about the questionnaire, please ask the receptionist.

When you have finished the questionnaire, place the completed questionnaire in an envelope and put it in the box at reception.

Remember, the answers are confidential and you will not be identified in any way.

We appreciate your time and help, and look forward to continuing to provide you with high-quality healthcare.

Yours faithfully,

The GPs and staff members at her Medical

To better understand the demographics of our clinic community we ask the following identifiers.

Are you?

MaleFemaleOther

Do you consider yourslef to be of Aboriginal and/or Torres Strait Islander decsent

YesNo

Which Language do you speak at home?

Have you been to another general practice in the last year

YesNo

How long have you been coming to the practice

Less than 1 year1-2 years3 years or moreNot sure

Was this visit for yourself or someone you are caring for?

SelfSomeone else

Comments

Do you have any comments you would like to make about making an appointment and waiting to see a clinician

Do you have any comments you would like to make about your experience with reception staff at your visit

Do you have any comments you would like to make about your experience with clinical staff at your last visit

Do you have any comments you would like to make about the way clinicians communicated with you at your last visit

Do you have any comments you would like to make about the information given to you by clinicians at your last visit

Do you have any comments you would like to make about your experiences of privacy at your last visit

Do you have any comments you would like to make about the way your clinician worked with other healthcare professionals at your last visit?

Do you have any comments you would like to make about your experience with the general practice over the last year

Q9. If you could change one thing about this practice, what would you change? *

Q10. Are you aware that this practice specializes in Iron Infusions? *

YesNoNot Sure

Q11. Have you ever received treatment at this practice for an iron infusion *

YesNoNot Sure

If no, please submit survey.

Do you have any comments you would like to make about the way your clinician worked with other healthcare professionals at your visit?

Thank you for taking the time to complete this questionnaire.