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Patient Survey
1.
Name of doctor:
Dr Philip Brook
Dr Jonathan Cabot
A/Prof Peter Cundy
Dr George Dracopoulos
Dr David Hermann
Dr M. Saleem Hussenbocus
Dr Mark Inglis
Dr Meng Ling
Dr Matthew Liptak
Dr Yu Chao Lee
Dr Daniel Mandziak
Dr James McLean
Dr Andrew Mintz
Dr Mario Penta
Dr Andrew Potter
Dr Anthony Samson
Dr Aman Sood
Dr Aaron Stevenson
Dr Peter Viiret
Dr Brian Wallace
Dr Jason Ward
Dr Darren Waters
Dr Justin Webb
Dr Nicole Williams
Prof Brian Freeman
2.
Location of appointment:
Memorial Medical Centre
Ashford Specialist Centre
Flinders Private
Parkside
Central Districts
Other (please specify)
3.
On a scale of 0 to 10,
How likely is it that you would recommend Doctor to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
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10
4.
On a scale of 1-10 (1 being poor and 10 being exceptional) how friendly were the Orthopaedics SA office staff?
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10
5.
On a scale of 1-10 (1 being poor and 10 being exceptional) how easy was it to schedule your appointment at a time that was convenient for you?
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10
6.
On a scale of 1-10 (1 being poor and 10 being exceptional) how satisfied were you with the amount of time the specialist spent with you to address your needs?
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10
7.
On a scale of 1-10 (1 being poor and 10 being exceptional) how convenient is the location of our rooms for your specialist appointment?
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10
8.
On a scale of 0 to 10,
How likely is it that you would recommend Orthopaedics SA to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
9.
Please make any further comments about your experiences with Orthopaedics SA:
10.
Please indicate who the survey was completed by:
Patient
Parent or guardian
Other person
11.
Please tell us your postcode:
12.
Would you like our management team to contact you to discuss your patient survey response with you? (If yes, please leave your contact details below)
Yes
No
13.
Contact Information
Name
Phone Number
Email
On behalf of Orthopaedics SA thank you for completing this survey. Once submitted you will be automatically re-directed to the Orthopaedics SA website.
