Patient Participation

We are actively seeking feed back from users of our service.

Patient Survey Questionnaire

Our records show that you recently used the services of GRABADOC for yourself or your child. In order to maintain the quality of our service we ask a random sample of patients who contact GRABADOC to complete a confidential questionnaire.

Could you please take a few minutes to complete the questionnaire below:

1. This section is for ALL patients

What services did you receive?

		tick appropriate

a.	Advice on the telephone
b.	Appointment at a local clinic
c.	A home visit
d.	Directed to casualty (A&E) or call 999

2. This section is for ALL patients

Please look at the following statements and for each one tick the box which is closest to your view.

		Agree	Disagree	Neither

a.	It was difficult to get through on the telephone
b.	My details were taken efficiently and courteously
c.	The doctor I spoke to was courteous and polite

3. This section is ONLY for patients who received only telephone advice

Please look at the following statements and for each one tick the box which is closest to your view.

		Agree	Disagree	Neither

a.	The doctor explained everything I needed to know
b.	I was satisfied with the advice I was given
c.	I got clear advice about how to get more help
d.	I was invited to contact the doctor again if necessary

4. This section is ONLY for patients who saw a doctor at one of the CLINICS

Please look at the following statements and for each one tick the box which is closest to your view.

		Agree	Disagree	Neither

a.	The clinic was easy to find and get to
b.	The doctor I saw examined me thoroughly
c.	To wait to see the doctor was too long
d.	The doctor saw was courteous and polite

5. This section is ONLY for patients seen by the GRABADOC doctor AT HOME

Please look at the following statements and for each one tick the box which is closest to your view.

		Agree	Disagree	Neither

a.	The doctor who visited examined me thoroughly
b.	The wait for the doctor to arrive was too long
c.	The doctor who visited was courteous and polite

6. This question is for ALL patients

		Yes	No

a.	Did you visit your GP about the same problem after receiving help from GRABADOC?

7. This section is for ALL patients

		tick appropriate

a.	I was very satisfied
b.	I was fairly satisfied
c.	I was neither satisfied or dissatisfied
d.	I was fairly dissatisfied
e.	I was very dissatisfied

8. Comments

9. Verification - please enter the word below (this helps us to minimise abuse of this form by automated means)

THANK YOU VERY MUCH FOR TAKING PART IN THIS SURVEY

Or download a copy of our survey here and return it to us in the pre-paid envelope. We would be grateful if you could return the form within a month of your original phone call to us?

We also have regular patient participation group meetings where service users or their guardians discuss possible ways of improving Grabadoc. If think you may be interested in participating please indicate this at the end of one of our patient survey questionnaires.