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Patient Survey 2026
1.
I am completing this form as:
The patient
The patient's parent / legal guardian
The patient's carer
2.
Please indicate patient's age:
Under 18
18-24
25-34
35-44
45-54
55-64
65-74
75-84
85 years or older
3.
Which of the following best describes you?
Male
Female
Non-Binary
Other
Prefer not to say
4.
From the current available options, how do you prefer to contact the Surgery?
Telephone
In Person
Online via Surgery website
Online via NHS App
5.
Do you use the services via the NHS App?
Yes, I am confident using the NHS App
Yes, but I need to refresh my skills
No, but I am willing to try it
No, I prefer contacting the surgery by other means
No, I don't know what the NHS app is
6.
Overall how satisfied are you with the process of accessing the service for a new medical problem?
Not applicable
Very satisfied
Satisfied
Neither satisfied or dissatisfied
Dissatisfied
Very dissatisfied
7.
Overall how satisfied are you with the process of accessing the service for an existing medical problem?
Not applicable
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
8.
What is your preferred appointment type?
I am happy to be guided by the Surgery on the most appropriate appointment to meet my needs
Face to Face
Telephone consultation
Video consultation
9.
Following the 2025 patient survey, the surgery now offers telephone appointments within a two hour window. If you have had a telephone call since May 2025, how satisfied were you with the service offered?
Not applicable
Very satisfied
Satisfied
Neither satisfied or dissatified
Dissatisfied
Very dissatisfied
10.
Who was your last appointment with?
Doctor
Nurse
Healthcare Assistant
Phlebotomist
Pharmacist
Mental health Nurse
First contact phyiotherapist
Midwife
11.
Thinking about your last appointment how satisfied were you with the treatment or advice you received?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
12.
Do you know how to provide feedback (positive or negative)on your experience of surgery services?
Yes
No
13.
Overall, please describe what aspect(s) of the surgery service provided satisfaction.
14.
Overall, please describe what aspect(s) of the surgery service provided dissatisfaction.