This questionaire is being sent to you on behalf of Gade Surgery Patient Participation Group which has been formed to represent the views of all our patients.The group is currently small but welcomes new members to attend occasional meetings at which we hope to discuss patient concerns and ways of improving the service we provide.

Under the direction of the Patient Participation Group we are undertaking an initial survey to review the service patients receive from us and hopefully to find areas we can work on. Please take a few minutes to complete and return this form to the practice, ticking the relevant box(s) and add your comments.

* 1. How would you rate our Reception team in relation to the following areas?

  Excellent Very Good Average Poor Very Poor
Politeness
Professionalism
Efficiency
Knowledge
Understanding my needs

* 2. How welcome are you made to feel when you arrive at the Reception desk

  Please tick one
Very Welcome
Welcome
Not very welcome
A bit of a nuisance

* 3. In reception area, do you feel that other patients can hear what you say to the Receptionist?

  please tick one
Yes but I don't mind
Yes and I am not very happy about it
No, I don't feel that other patients can overhear

* 4. We have introduced a computerised check-in system at the main surgery. Do you find this helpful?

  Please tick one
I like the booking-in screen, it saves time
I like the booking-in screen, it saves me having to queue
I find the booking-in screen difficult to use
I prefer to book in with a member of staff
Don't know

* 5. How informative do you find the notice boards in the Waiting Room?

  Please tick one
Very useful
Useful
Not at all useful
Nothing of interest

* 6. How easy is it for you to get through to us on the telephone

* 7. Gade Surgery Practice Website

* 8. Equality and Diversity Monitoring Form Age Group

  Please tick one box
16-19
20-24
25-29
30-34
35-39
40-44
45-49
50-54
55-59
60-64
65 and over

* 9. Gender

  Please tick one box
Male
Female
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