Skip to content
Check Screen Reader Mode to make this survey compatible with screen readers.
Check Screen Reader Mode to make this survey compatible with screen readers.

HERNIA SERVICE PATIENT FEEDBACK FORM APRIL 2026- MARCH 2027

We would be grateful if you would complete this feedback form following your recent hernia repair procedure. If possible this form should be completed approximately 6 weeks after your operation.
We aim to deliver complete patient satisfaction, collecting and acting on our patient feedback is vital to our achieving this; your opinions are therefore very valuable.

Please note this is an anonymous survey, please contact us directly if you need a response.
1.How likely are you to recommend our clinic to friends or family if they needed similar care or treatment?
2.Were you treated with courtesy throughout your appointment(s) by administration staff and the health professionals?
3.Were you given clear explanation of your condition, any medication requirements, and your treatment?
4.Were you involved as much as you wanted to be in decisions about your care and treatment?
5.How did you find the injection of local anaesthetic?
6.How effective was the local anaesthetic in preventing pain during the operation?

On a scale of 1-10 with 1 being not at all & 10 being completely
7.Were the painkillers provided after surgery satisfactory?
8.Did you have an infection requiring antibiotics?
9.Did you have any of the following complications? please tick as appropriate
10.Finally, we would be grateful for any of your own comments regarding the treatment you received, the service as a whole or any part of it.
11.Procedure date
Date
Current Progress,
0 of 11 answered