Skip to content
Yiewsley Family Practice Online Web Form Feedback Survey
1.
Have you used the new Yiewsley Family Practice online web form?
Yes
No
2.
Please tell us why you have not used the online form.
3.
Overall, how has your experience of using the new online web form been?
Very Good
Good
Fair
Poor
Very Poor
4.
Please tell us about your experience of using the online form.
5.
What, if anything, worked well for you when using the online form?
6.
What problems or difficulties have you experienced when using the online form?
7.
Is there anything about the online form that you find difficult?
8.
On a scale of 0 to 10,
How likely is it that you would recommend the new online web form to a friend or colleague?
0 for Not at all likely, 10 for Extremely likely
Not at all likely
Extremely likely
0
1
2
3
4
5
6
7
8
9
10
9.
Do you have any suggestions for improving the online web form?