Online Feedback Question Title * 1. Personal Information (Optional) Name Email Address Phone Number Question Title * 2. Visit Details Date Of Visit Name of GP/Nurse/Staff memebr Reason for Visit Question Title * 3. How easy was it to book your appointment? Very easy Easy Neither easy nor difficult Difficult Very difficult Any comments or suggestions for improving the appointment booking process? Question Title * 4. How would you rate the waiting time for your appointment? Very Short Short Neutral Long Very Long Any comments or suggestions for improving waiting times? Question Title * 5. How would you rate the quality of your consultation? Excellent Good Neutral Poor Very Poor Question Title * 6. Did you feel listened to and understood by the healthcare professional? Yes No Any comments or suggestions for improving the consultation experience? Question Title * 7. Would you recommend our practice to others? Yes No Question Title * 8. Is there anything else you would like to share about your experience or any other suggestions for improvement? Question Title * 9. Do you consent to your feedback being used for training and quality improvement purposes? Yes No Question Title * 10. If required are you happy to be contacted regarding your feedback? Yes No If yes, please provide your preferred contact method (Email/Phone): Done
