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HVS ASPC VASECTOMY OPERATION DAY QUESTIONNAIRE 2025-26

Operation Day Questionnaire

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1.Did you experience any problems booking your vasectomy appointment?
(Required.)
2.How good was the information leaflet sent to you prior to your appointment to prepare you for today’s operation?(Required.)
3.How useful did you find the consultation with the Doctor/Nurse before the operation?(Required.)
4.Did you feel comfortable having this procedure done at this surgery?(Required.)
5.How do you rate the theatre, premises and facilities available here for today's operation?(Required.)
6.How did you rate the Doctor's manner and communication during the operation?(Required.)
7.How did you rate the Assistant (s) during your appointment with us? (Required.)
8.How would you describe the level of pain you felt during the initial injection(s) for the operation?(Required.)
9.How would you describe the level of pain you felt for the rest of the operation?(Required.)
10.At which Surgery did you have your operation today?(Required.)
11.Which Doctor operated on you today?(Required.)
12.Thinking about the service we have provided, overall, how was your experience of our service?(Required.)
13.Please tell us about anything that we could have done better
14.How would you describe the level of anxiety you felt BEFORE the operation?(Required.)
15.How would you describe the level of anxiety you felt DURING the operation?(Required.)
16.Finally feel free to provide any further comments on the questions above or compliments/suggestions regarding your Vasectomy & our Service
17.Please give us any Anonymous PID number you were given. Leave blank if never given one