Family Planning Service

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Information

You have been sent this questionnaire because you have had a family planning appointment at Northgate Medical Practice.

Yourfeedback is extremely valuable and would be greatly appreciated.

Your comments will help us to continue to develop and improve services, so please try to complete this as fully as possible. This questionnaire will remain anonymous and your subsequent treatments will not be affected by your response.

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Type of procedure

Type of procedure:

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Waiting Time

Once your GP had seen you, how long did you have to wait for your family planning appointment?:

Was this time::

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Appointment Experience

Did you find it easy to get to the clinic for your appointment?:

Were you seen on time?:

Were you informed why your appointment was not on time?:

Did you feel that the time you spent with the clinician was long enough?:

Did you feel that your appointment with the clinician was thorough enough?:

Were you able to ask any questions throughout your procedure?:

Were you happy with the explanations given to you during your appointment?:

Taking everything into account, how would you rate the overall quality of care of the service you received?:

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Age Group

It would help us to ensure that we have collected the views of all our patients, if you could provide us with the following information:

Are you::

Thank you for taking the time to complete this questionnaire about your family planning appointment.

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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Family Planning Service

Privacy Consent

NORTHGATE MEDICAL PRACTICE

BLEAN BRANCH SURGERY

CHARTHAM SURGERY

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