Patient Feedback Questionnaire Thank you for taking the time to complete our online questionnaire! The information you provide is valuable to us and will help us develop and improve our services to you in the future. OK Question Title * 1. When did you visit us? Date: Date OK Question Title * 2. Which of our services did you use today? MRI Scan Ultrasound Consultation X-Ray CT Scan Physio OK Question Title * 3. From first contact, how long did you have to wait for a suitable appointment? 24 hours or less 48 hours or less More than 48 hours - no availability More than 48 Hours - my choice OK Question Title * 4. On the day of your appointment, was the length of time spent waiting to be seen by a specialist reasonable? Yes No OK Question Title * 5. Were you made to feel comfortable throughout the procedure by clinic staff? Yes No OK Question Title * 6. Were you treated with privacy, and with dignity at all times during your visit? Yes No OK Question Title * 7. Were you told how to find out the results of your procedure/scan and the time period in which you would receive them? Yes No OK Question Title * 8. From booking to attending your appointment, were your questions and queries answered and dealt with efficiently? Yes No OK Question Title * 9. Would you recommend Harley Street Medical Centre to family and friends? Yes No OK Question Title * 10. How was your treatment funded? Insured Self-Pay NHS Embassy Other OK Question Title * 11. How would you rate the following aspects of the service?Before your appointment Excellent Good Poor The ease and efficiency of the booking process The ease and efficiency of the booking process Excellent The ease and efficiency of the booking process Good The ease and efficiency of the booking process Poor Knowledge and helpfulness of booking staff Knowledge and helpfulness of booking staff Excellent Knowledge and helpfulness of booking staff Good Knowledge and helpfulness of booking staff Poor Relevance and quality of information received prior to visit Relevance and quality of information received prior to visit Excellent Relevance and quality of information received prior to visit Good Relevance and quality of information received prior to visit Poor OK Question Title * 12. How would you rate the following aspects of the service?On arrival Excellent Good Poor Greeting and promptness of attention on arrival Greeting and promptness of attention on arrival Excellent Greeting and promptness of attention on arrival Good Greeting and promptness of attention on arrival Poor Comfort and surrounding of waiting room Comfort and surrounding of waiting room Excellent Comfort and surrounding of waiting room Good Comfort and surrounding of waiting room Poor Cleanliness and tidiness of centre Cleanliness and tidiness of centre Excellent Cleanliness and tidiness of centre Good Cleanliness and tidiness of centre Poor Facilities available (e.g. toilets, changing rooms) Facilities available (e.g. toilets, changing rooms) Excellent Facilities available (e.g. toilets, changing rooms) Good Facilities available (e.g. toilets, changing rooms) Poor OK Question Title * 13. How would you rate the following aspects of the service?Centre staff Excellent Good Poor Efficiency and courteousness of reception staff Efficiency and courteousness of reception staff Excellent Efficiency and courteousness of reception staff Good Efficiency and courteousness of reception staff Poor Efficiency and courteousness of clinical staff Efficiency and courteousness of clinical staff Excellent Efficiency and courteousness of clinical staff Good Efficiency and courteousness of clinical staff Poor Efficiency and courteousness of consultants Efficiency and courteousness of consultants Excellent Efficiency and courteousness of consultants Good Efficiency and courteousness of consultants Poor OK Question Title * 14. We would greatly value any comments or suggestions you may have relating to the services you received today: OK Question Title * 15. If there is any member of staff who gave you especially good service, please provide their name here: OK SUBMIT
