Children's Orthopaedics

Please tell us about your patient experience

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* 1. Date

Date / Time

Date

Thinking about your visit to our hospital

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* 2. Overall, how was your experience of our service?

Very good

Good

Neither Good nor Poor

Poor

Very poor

Don't know

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* 3. Please can you tell us why you gave your answer?

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* 4. Please tell us what we could have done better.

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* 5. olijojo

Please tick this box if you DO NOT wish for your comments to be made public

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* 6. What is your child's gender

Male

Female

Non-gender conforming

Non-binary

Prefer not to say

Prefer to self-describe

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* 7. What age is your child?

0-15

16-24

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* 8. What religion are your family?

Christianity

Islam

Hinduism

Sikhism

Judaism

None

Other Religion

Prefer not to say

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* 9. What is your child's ethnic group?

White

Mixed/Multiple ethnic groups

Asian/Asian British

Black/African/Caribbean/Black British

Other

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* 10. Are your child's day to day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12 months?

Yes

Prefer not to say