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* 1. On leaving your GP were you given an information sheet and explained what would happen next concerning your referral?

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* 2. Did you find the information you received in your appointment letter useful?

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* 3. Were you contacted by the Referral Management & Booking Service/ Referral Support Service within 10 days of visiting the surgery

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* 4. Was the method of being offered an appointment by telephone useful?

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* 5. Did the booking officer explain what was happening to your booking and your choices?

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* 6. Was the booking officer knowledgeable and efficient on your choices and accessed your details correctly 

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* 7. Do you feel you were given enough information on the call?

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* 8. Were staff members professional and respectful during your conversation?

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* 9. Did you receive a referral booking that matched the choices available?

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* 10. Did you receive confirmation in the post?

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* 11. Overall, were you happy with the service received from the Referral Management & Booking Service/ Referral Support Service?

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* 12. How would you rate your overall experience compared to any previous practice booked referrals?

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* 14. Can you please indicate what GP practice you are registered with?

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* 15. Please could you list your Unique Booking Reference Number (UBRN) below along with any other comments

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