Patient Feedback Questionnaire — Severn Valley Medical Practice

Firstly, please tell us the name of your usual doctor.

Thinking of times when you want to see a particular doctor:

Thinking of times when you are willing to see any doctor:

Thinking of times you have phoned the practice, how do you rate the following:

These next questions ask about your usual doctor. If you don't have a 'usual doctor', answer about the one doctor at your practice who you know best. If you don't know any of the doctors, skip this section.

Thinking about when you consult your doctor, how do you rate the following:

Thinking about the nurse(s) you have seen, how do you rate the following:

Finally, it will help us to understand your answers if you could tell us a little about yourself:

We are interested in any other comments you may have. Please enter these in the box below.

Feedback Questionnaire.

Let us know what you think.

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