GP Ophthalmology Service Questionnaire

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Appointment Details

You have been asked to fill in this questionnaire because you have been sent an appointment at Northgate Medical Practice specialist GP Ophthalmology clinic.

Your feedback is extremely valuable and would be greatly appreciated. This is a service that has been set up in order to reduce the time that you have to wait to see an Ophthalmology specialist, and to improve access to this service.

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.

Waiting Time
Appointment Experience
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:

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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