Patient Satisfaction Questionnaire - Outpatients

1. About You
Under 1819-3435-5455-7475+
2. On what basis was payment made for your visit?
3. What influenced you to choose The London Orthopaedic Clinic
4. Would you recommend The London Orthopaedic Clinic to friends and family?
5. First Impressions?
Very GoodGoodFairPoor
Efficiency of appointment booking
Information given prior to arrival
convenience of appointment
Overall impression
6. On Arrival
Very GoodGoodFairPoor
Directions to appropriate floor
Greetings on arrival
Waiting room comfort
Promptness of attention
Overall impression
7. Availability of Amenities
Very GoodGoodFairPoor
Quality of refreshments
Disabled facilities
Conditions of restrooms/waiting area
Overall impressions
8. Consultant Care - Speed in which you were seen
9. Which Consultant did you see?
10. Consultant Care
Very GoodGoodFairPoor
Explanation of presenting condition and treatment options
Level of privacy when undressing
Overall consultant care
11. Nursing care - speed in which you were seen
12. Nursing Care
Very GoodGoodFairPoor
Explanation of procedure
Explanation of aftercare
Time & attention given
Overall nursing care
13. Radiology - Speed in which you were seen
14. Radiology
Very GoodGoodFairPoor
Explanation of procedure
Time & attention given
Courtesy of staff
Overall Care
15. Financial administration
Very GoodGoodFairPoor
Assistance with financial queries
Ease of financial arrangements
16. Comments & Suggestions
17. If you would like to be contacted about any of these points please include your name and address below.
18. Please let us know if you are happy for your comments to be used on our website ( N.B No names or details will be mentioned)
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