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Friends and Family Test Feedback
We would like you to think about your experience of using our services
1.
What service did you use?
Inpatient/Ward stay
Outpatient/Clinic
Accident and Emergency- Adults
Accident and Emergency- Children
Maternity
Other (please specify)
2.
Please tell us the name of the ward or department
3.
Overall, how was your experience of our service?
Very good
Good
Neither good nor poor
Poor
Very poor
Don't know
4.
Please can you tell us why you gave that answer?
5.
Please tell us about anything we could have done better
6.
Are you male or female?
Male
Female
7.
Do you have a disability?
Yes
No
8.
If you answered yes to Question 7, what type of disability do you have?
Hearing
Vision
Mobility
Other (please specify)
9.
Please state your ethnic origin
10.
Please state your religion
11.
Are you happy for your comments to be made public
Yes
No
Current Progress,
0 of 11 answered
