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Ashley Surgery Patient Group Survey 2012

Ashley Surgery Patient Group Survey 2011/2012 The Old School Ashley TF9 4LF. Contact Number 01630-672225 Please complete the form below.

1. How do you rate the overall service and care you receive from the practice? Very Satisfied Fairly Satisfied Neither Fairly Dissatisfied Very Dissatisfied 2. In the past 12 months how many times have you seen a doctor / nurse? 3. On pre-booked appointments which doctor do you normally see? Dr Shilvock Dr Bladen Other 4. Are you satisfied with the care provided by that doctor? Please make any comments: Yes No   5. Regarding booking appointments what improvements / changes would you like to see? 6. Do you make appointments or book medication online and what would you like to see improved with this service? Yes No   7. Are you satisfied with the current same day appointment system? Yes No 8. Regarding the same day appointments what improvements / changes would you like to see? 9. Are you aware of what services our practice nurses provide? Yes No 10. Are you aware of the Patient Group and how to contact them? Yes No 11. Are you aware of the Virtual Patient Group? Yes No 12. What age are you? Under 16 17 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 Over 84 13. What is your gender? Male Female 14. What ethnic background do you most identify with? White British White Irish Mixed White & Black Caribbean Mixed White & Black African Mixed White & Black Asian Indian Pakistani Bangladeshi Black Caribbean Black African Chinese Other   15. If you wish to make any further comments please do so here. All information given will be treated in the strictest confidence and will not in any way prejudice your current position / relationship with this practice