Patient Feedback Survey 2017
Thank you for taking the time to complete this short survey. The questions have been put together with the assistance of our “Virtual Patient Group” and we are grateful for their input. If you would like to become a member of our VPG, please advise us by sending an e mail to us at email@example.com – we promise we will not inundate you with e mails and will never share your address with anyone.
You can either complete the form online below, or if you wish you can click here to download the survey and either return the completed form to the surgery or email it to firstname.lastname@example.org
Please complete the form as honestly and accurately as possible. Please remember, your anonymity is guaranteed. I will personally collate results and any communication of them, even inside the practice, will not identify individuals.
Please score each question as follows:-
5 = Agree strongly
4 = Agree slightly
3 = Don’t know/Not sure
2 = Disagree slightly
1 = Disagree strongly