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* 1. What is your gender?

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* 2. What is your age?

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* 3. How long have you been coming to this practice?

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* 4. Making an appointment and waiting to see your GP at your last visit

  Poor Fair Good Very Good Excellent
Seeing the GP of your choice
Getting an appointment for a time that suited you
The time you had to wait to get this appointment (before getting to the clinic)
The time you had to wait after you arrived at the clinic
The comfort of the waiting room

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* 5. Your experience with reception and nursing staff at your last visit

  Poor Fair Good Very Good Excellent
Were welcoming upon your arrival
Were professional in dealing with you
Considered your needs when making an appointment
Let you know about any delays while you were waiting
Were courteous and polite

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* 6. Your experience of the way your GP communicated with you at your last visit

  Poor Fair Good Very Good Excellent N/A
Treated you with respect
Understood your personal circumstances
Helped you understand your medical condition
Explained the purpose of tests and treatment
Involved you in decisions
Helped you understand what to do when you went home
Really listened to what you had to say
Allowed you to have final choice about tests and treatments

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* 7. Your experience of the information given to you by your GP at your last visit

  Poor Fair Good Very Good Excellent N/A
The amount of useful information given about your condition and treatment
Information about how to take your medicines
Information about side effects of any treatment
Gave you useful written information
Told you where to find reliable information on the internet

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* 8. Your experience of privacy at your last visit

  Poor Fair Good Very Good Excellent N/A
Privacy when you were examined
Being able to discuss personal issues that were sensitive
Your understanding how medical records are kept private in the clinic
The way in which information was given to other Doctors

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* 9. Your experience of the was your GP works with other healthcare professionals

  Poor Fair Good Very Good Excellent N/A
Your GP was aware of advice you had received from another health professional
Gave you options for specialists or other health providers you need to see
Coordinated different health care professionals
Allowed you to have the final choice about which other health professional to see

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* 10. Thinking about your experience with the general practice over the past year

  Poor Fair Good Very Good Excellent
Suitability of clinic opening hours
Being able to see a Doctor at the clinic when you needed urgent care
Information about where to get medical care when the clinic is closed
Providing your test results in an understandable way

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* 11. If you could change one thing about this practice, what would you change?

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