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Patient Satisfaction Survey
East Croydon Medical Centre
We would like to ask you about your experience regarding your last visit to the practice. Thank you for helping us continue to improve the care we provide for our patients.
*
1.
Age: Please select the appropriate age group.
(Required.)
Under 18
18-24
25-34
35-44
45-54
55-64
65+
*
2.
Gender: Please select your gender.
(Required.)
Male
Female
Non-Binary
Other (please specify)
*
3.
How would you rate the overall quality of service you received at our practice?
(Required.)
Very good
Good
Fair
Poor
Very poor
*
4.
Did you find it easy to schedule an appointment with our practice?
(Required.)
Yes
No
Not applicable
*
5.
How long did you have to wait for an appointment from when you first contacted the practice? (This includes telephone or face-face appointments).
(Required.)
Same day
1-2 day(s)
2-5 days
1-2 weeks
2 weeks+
*
6.
What method did you use to book your appointment today?
(Required.)
Telephone
Online (eConsult)
Other (please specify)
*
7.
How would you rate the professionalism and friendliness of our staff?
(Required.)
Excellent
Good
Fair
Poor
*
8.
Were you provided clear information regarding your health condition and were you involved in your treatment plan?
(Required.)
Yes
No
Partially
*
9.
How long were you waiting for to be seen?
(Required.)
0-5 minutes
5-10 minutes
10-15 minutes
15 minutes+
*
10.
Were you treated with respect and dignity during your visit to our practice?
(Required.)
Yes
No
Not applicable
*
11.
Did you receive appropriate follow-up care or instructions after your visit to our practice?
(Required.)
Yes
No
Not applicable
*
12.
On a scale of 0 to 10,
How likely is it that you would recommend our practice to a friend or family member?
0 for Not at all likely, 10 for Extremely likely
(Required.)
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
13.
Is there any specific area where you believe our practice could improve its services?
*
14.
Would you be interested in joining our patient's participation group? This allows you to be involved in changes in the practice and join our quarterly meetings to give us feedback.
(Required.)
Yes
No
15.
If yes to Q14, kindly leave your details below:
Name
Date of Birth
Email Address
Phone Number
