GPHP ECG Service Patient Survey

Your Visit

Having been seen in GPHP's Cardiology Diagnostic Service recently, for a 12-lead ECG or ambulatory holter monitor, we would be grateful if you could answer a few questions about the care you received to assist us with ongoing evaluation and review. All responses will remain confidential and we thank you for your time in completing this.

Question Title

* 1. Do you feel you received an appointment in a timely fashion. Please note, owing to demand and time to process holters, several weeks wait is usual.

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

Question Title

* 2. Please rate the following

	Poor	Needs Improvement	Acceptable	Good	Excellent
Communication about the appointment	Communication about the appointment Poor	Communication about the appointment Needs Improvement	Communication about the appointment Acceptable	Communication about the appointment Good	Communication about the appointment Excellent
Information about where to find the clinic	Information about where to find the clinic Poor	Information about where to find the clinic Needs Improvement	Information about where to find the clinic Acceptable	Information about where to find the clinic Good	Information about where to find the clinic Excellent
Helpfulness of reception team	Helpfulness of reception team Poor	Helpfulness of reception team Needs Improvement	Helpfulness of reception team Acceptable	Helpfulness of reception team Good	Helpfulness of reception team Excellent
Appointment reminder text	Appointment reminder text Poor	Appointment reminder text Needs Improvement	Appointment reminder text Acceptable	Appointment reminder text Good	Appointment reminder text Excellent
The care provided by the Health Care Assistant	The care provided by the Health Care Assistant Poor	The care provided by the Health Care Assistant Needs Improvement	The care provided by the Health Care Assistant Acceptable	The care provided by the Health Care Assistant Good	The care provided by the Health Care Assistant Excellent

Question Title

* 3. Do you feel that during your appointment appropriate information was provided relating to the procedure?

Agree

Neutral

Disagree

Question Title

* 4. If you had a holter monitor fitted, did the Health Care Assistant give you adequate instructions?

Yes

Not applicable

Comments

Question Title

* 5. If you collected a holter to fit yourself, did you find the instructions easy to follow and the process to return straightforward?

Yes

Not applicable

Comments

Question Title

* 6. Do you feel your privacy and dignity were respected?

Strongly Agree

Agree

Neutral

Disagree

Strongly Disagree

If you disagree, please state why.

Question Title

* 7. Please rate the appearance & cleanliness of the waiting room & consultation room

Very Poor

Adequate

Good

Very Good

Excellent

Very Poor

Adequate

Good

Very Good

Excellent

Question Title

* 1. Do you feel you received an appointment in a timely fashion. Please note, owing to demand and time to process holters, several weeks wait is usual.

Question Title

* 2. Please rate the following

Question Title

* 3. Do you feel that during your appointment appropriate information was provided relating to the procedure?

Question Title

* 4. If you had a holter monitor fitted, did the Health Care Assistant give you adequate instructions?

Question Title

* 5. If you collected a holter to fit yourself, did you find the instructions easy to follow and the process to return straightforward?

Question Title

* 6. Do you feel your privacy and dignity were respected?

Question Title

* 7. Please rate the appearance & cleanliness of the waiting room & consultation room

Question Title

* 8. Do you have any other comments, questions, or concerns?