1. Feedback questionnaire

This one minute questionnaire has been designed for you and your partner to provide an evaluation of your treatment at Assisted Conception Australia (ACA).

We value your suggestions and comments, and will endeavour to use your feedback to improve ACA's services for the benefit of those in need of fertility advice and treatment. (All comments and suggestions will remain confidential).

If you wish to provide a more detailed response, please email your comments to Clare Jamieson at info@acaivf.com.au

Thank you for choosing ACA.

Drs Clare Boothroyd and Steven Fleming

* 1. Name

* 2. Contact Details

* 3. Treatment received at Assisted Conception Australia

* 4. Was your treatment successful?

* 5. How would you rate your overall experience at Assisted Conception Australia?

* 6. How convenient was it for you to access the Assisted Conception Australia fertility centre?

* 7. How would you rate the information you received?

* 8. Was the fertility treatment that you received value for money?

* 9. How would you rate the professionalism and efficiency of the ACA team?

* 10. If you have any any other comments or suggestions that you think would help us to improve fertility treatment at Assisted Conception Australia, please add a note here. Thank you.