We appreciate you taking the time to give feedback. Your responses will help us to find ways to improve our services for patients and visitors.

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* 1. Which ward are you visiting?

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* 2. Have you received the following? Please tick all tick all that apply.

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* 3. How much do you agree with the following: The information booklet is useful / relevant.

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* 4. The reception team were welcoming.

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* 5. My request for a Doctor was accommodated.

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* 6. My concerns and questions have been answered

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* 7. Staff have explained equipment, procedures and tests, where appropriate.

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* 8. I have been supported by staff.

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* 9. My relative / friend is receiving high quality care.

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* 10. My relative / friends privacy and dignity are respected.

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* 11. Staff communicate well with patients.

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* 12. The unit is clean

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* 13. Hand washing / hand gel facilities are accessible

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* 14. We have been offered privacy as a family when needed.

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* 15. The toilets are accessible and clean

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* 16. I have been able to access refreshments when needed

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* 17. The waiting area is clean and tidy

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* 18. The visiting hours are reasonable

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* 19. Do you have any comments, suggestions or feedback you would like to give?

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