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Easy Read Maternity FFT - Postnatal Ward
1.
Which hospital did you go to?
Royal Shrewsbury Hospital
Princess Royal Hospital
2.
Today's date is
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
3.
How was your experience?
Very good
Good
Neither good nor poor
Poor
Very poor
Don't know
4.
What was good about your care?
5.
What could be better?
6.
Can we share your comments anonymously?
Anonymous means we wont include your name or details.
Yes
No
7.
My age is
8.
Are your day-to-day activities limited due to a health problem or disability?
Yes, limited a lot
Yes, limited a little
No
Don't know / Don't want to say
9.
What is your gender?
Male
Female
Non binary
Other
I don't know / I don't want to say
10.
Trans is a word used to describe someone whose gender is not the same as what they were assigned at birth.
Do you consider yourself to be a trans person?
Yes
No
Other
I don't know / I don't want to say
11.
What is your sexual orientation?
Heterosexual / straight
Gay woman / lesbian
Gay man
Bi / bisexual
Other
I don't know / I don't want to say
12.
What is your ethnic group?
White
Asian / Asian British
Black / Black British
Mixed / Multiple Ethnic Groups
Other Ethnic Group
I don't know / I don't want to say
Current Progress,
0 of 12 answered
