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Outpatient Visit Survey
How old are you?
0-18
19-30
31-50
56-64
65+
What is your ethnicity?
What is your nationality?
Is English your first language?
Yes
No
Which Outpatient site did you visit?
To which Department does your response refer to?
How satisfied were you with the length of time from your GP referring you to being contacted about an appointment?
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
How satisfied were you with the date/time of your appointment?
Satisfied
Neither satisfied nor dissatisfied
Dissastisfied
Was your appointment on time?
Yes
No
If you needed to change/cancel your appointment, how satisfied were you with doing this?
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
How satisfied were you with receiving your appointment letter?
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
If signed up to this facility, did you feel that the texts you received were a useful reminder of your appointment?
Yes
No
N/a
Did you feel you had a good understanding of the outcome of your appointment and what to expect next?
Yes
No
Would you like to be able to book and manage your own appointment online?
Yes
No
Would you like, if clinically suitable for your health needs, to be able to have a telephone appointment instead of attending a clinic in the hospital setting?
Yes
No
Would you like, if clinically suitable for your health needs, to be able to have a video appointment instead of attending a clinic in the hospital setting?
Yes
No
Would you like, if clinically suitable, to be able to manage how often you come for your appointments and only attend an Outpatient appointment if you felt it was needed?
Yes
No
If the hospital offered Outpatient appointments at different locations other than the hospital site (i.e. GP surgeries, one stop hubs) would you be happy to attend there?
Yes
No
Please leave any additional comments in the box below:
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