Bucks THT Professsional Consultations
1.
Were you offered a chlamydia test today?
yes
no
Other (please specify)
2.
If so, were you given clear information about how to complete the form, use the test and receive the results?
yes
no
Other (please specify)
3.
Did you know about the C Card (free condoms) service before today?
yes
no
Other (please specify)
4.
Were you given information on where to pick up free condoms in Buckinghamshire?
yes
no
Other (please specify)
5.
How would you rate your overall experience today?
Poor
Could Improve
Ok
Good
Excellent
Suggestions to improve
6.
Would you recommend this service to a friend?
Yes
No
Other (please specify)
7.
What is your gender?
Female
Male
Other (please specify)
8.
What is your ethnicity?
White
Black or Black British
Asian or Asian British
Mixed
Other (please specify)
9.
What is your age?
10.
What district do you live in?
High Wycombe
Aylesbury Vale
South Bucks
North Bucks