QML Pathology Patient Experience Survey

Thank you for using QML Pathology services.

Your feedback is important to us and we appreciate your time.

Data collected will be kept strictly confidential and will only be used for internal improvement purposes.

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* 1. What was your interaction with QML Pathology?

I attended a QML Collection Centre

I was attended by a QML Pathology collector at my residence

Other (please specify)

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* 2. What date did we provide a collection service for you?

Date

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* 3. What is your gender?

Female

Male

Prefer not to disclose

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* 4. What age group do you fall under?

Under 18

18 - 30

31 - 45

46 - 60

Over 60

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* 5. If you attended a Collection Centre, which Collection Centre did you attend? Please provide specific location if possible.

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* 6. How satisfied are you with the appearance and comfort of our Collection Room?

Extremely satisfied

Moderately satisfied

Neither satisfied nor dissatisfied

Moderately dissatisfied

Extremely dissatisfied

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* 7. How long did you have to wait today at the Collection Centre or when booking in your home visit collection?

Under 10 mins

10 - 20 mins

20 - 30 mins

If longer, please specify

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* 8. Did the Collector answer all your questions to your satisfaction?

Yes

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* 9. How likely is it that you would recommend QML Pathology to a friend or colleague?

Not at all likely

Extremely likely

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* 10. Please tell us what QML Pathology can do to improve your patient experience. If there is a particular QML employee you would like to acknowledge, please provide their name and what they did well.

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* 11. Would you like a customer service representative to contact you about your experience with QML Pathology? (If Yes, please supply full name and contact details on the next page)

Yes

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* 12. Your contact details (Optional)

Full Name:

Email Address:

Phone Number: