            Patient Feedback Survey

1.Date of attendance

2.What was the purpose of your visit?(Required.)

Other (please specify)

Prior to your visit:

3.You found contacting the clinic easy and helpful.

4.Making an initial consultation appointment was straightforward.

During your visit:

5.You were involved in making decisions about your treatment

6.Your privacy and dignity were preserved at all times.

7.Clinical staff provided clear and sufficient instructions.

8.You are satisfied with the level of clinical support you received before, during and/or after your treatment.(Required.)

Additional comments

9.Any pain, discomfort or distress was managed effectively.

10.Information regarding progress of treatment was provided, including next steps.

11.You were seen by appropriate staff within a timely manner.

12.The cleanliness of the site was of a good standard.

13.Information regarding the Counselling Service has been regularly provided to you.

14.You are satisfied with the level of emotional support that you have received before, during and/or after your treatment.(Required.)

Additional Comments:

16.Finally, was there anything Cambridge IVF could have done to make your experience better? How could we improve?

Thank you very much for completing this Satisfaction Survey. Please check that you have answered all questions that apply to you and click 'done'.

Please note this survey response is anonymous. Therefore we are unable to respond to individual comments made. If you would like to receive a response please leave your name and email address below. Thank you.

17.Name and email address

Name

email address