Patient Survey

We would be very grateful if you could fill in this year’s patient survey, many thanks

Patient Survey

Thank you for agreeing to complete this survey which has been designed and run by your Patient Participation Group. It should only take 5 minutes of your time and the results will be valuable when helping shape and improve the services on offer from our practice.


Patient Survey
Please use format day/month/year e.g. 12/05/1979

Do You Know?

Do you know that there is a self referral physiotherapy service?
Do you know that there is a Mental Health and Wellbeing Peer Review service in the practice 3 days per week?
Do you know the services our Advanced Nurse Practitioners offer?
Do you know the services our Practice Nurses offer?
Do you know the services our Health Care Assistant offers?
Do you know that you can now use econsult 24 hours a day 7 days per week?
Do you know that there is a social prescriber based in the practice?
Do you know how to make a complaint?
Do you know that the practice has a Patient Participation Group?
Do you know what a Patient Participation Group does?
Do you know that the practice has a brand new website?
Do you know that you can use the website to order medication?
Do you know that you can use the website to use econsult?
Do you know that you can use the website to update your details?
Do you know that you can use the website to self refer to specialities?
Do you understand how results of samples taken in the practice will be shared with you?

Your Views

Please rate the following on a scale of very poor to very good or mark Not Applicable if you feel unable to comment on this service
Physical access to the practice
Appointment availability with a Doctor
Appointment availability with a Advanced Nurse Practitioner
Appointment availability with a Practice Nurse
Appointment availability with a Healthcare Assistant
Appointment availability with Mental Health and Well Being Service
Appointment availability with Physiotherapy Service
Your ability to make an appointment easily
The Practice Phone system
The system for ordering repeat prescriptions
Your ability to see the same doctor regularly
Do you think being able to see the same doctor regularly is important?

Your Details

Your age
How long have you been registered with the Practice?

Privacy Policy

This form collects your name, date of birth, email, other personal information and opinions. This is to confirm you are registered with the practice and to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.