The Practice Ophthalmology Ealing Patient feedback questionnaire Question Title * 1. Please select where you had your appointment: Grand Union Village Health Centre, Notholt Hanwell Health Centre, Ealing Other (please state) Other (please specify) Question Title * 2. Are you Patient Carer Question Title * 3. The attitude and helpfulness of the staff when booking your appointment Unsatisfactory Poor Average Good Very Good Unsatisfactory Poor Average Good Very Good Question Title * 4. 2. The quality of literature you received regarding your appointment e.g. letter, leaflet, map, etc. Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 5. Waiting time for an appointment Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 6. The ease of finding the clinic Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 7. Access to the clinic (parking, disabled access) Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 8. The speed in which you were seen on the day Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 9. The environment and patient facilities at the clinic e.g. toilets, waiting area, etc Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 10. The attitude of the doctor Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 11. How well the doctor listened to you Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 12. Explanation of your treatment Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 13. Explanation of follow-up treatment plan Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 14. Info on who to contact if you have a problem Unsatisfactory Poor Average Good Very Good Unsatisfactory Poor Average Good Very Good Question Title * 15. Overall consultation satisfaction Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 16. How likely are you to recommend the service to friends or family? Unsatisfactory Poor Average Good Very good Unsatisfactory Poor Average Good Very good Question Title * 17. Comments: (please leave your name and phone number if you would like us to contact you regarding your comments) Done