Churchmere Medical Group

Patient Survey

Churchmere Medical Group would like to know how you feel about the services we provide so we can make sure we are meeting your needs. Your responses are directly responsible for improving these services. All responses will be kept confidential and anonymous. Thank you for your time.

Are you

Male

Female

What is your ethnic origin?

What is your age?

16 - 25 years

26 - 49 years

50 - 65 years

Over 65 years

Are you aware of the extended hour service we provide?

Yes

No

If Yes – How satisfied are you with this service? Please score on a scale of 1-5, where 1 = ‘Not’ and 5 = ‘Very’

1

2

3

4

5

Are you aware of ‘POD’ Prescription Ordering Direct service?

Yes

No

If Yes – How satisfied are you with this service? Please score on a scale of 1-5, where 1 = ‘Not’ and 5 = ‘Very’

1

2

3

4

5

Are you aware of the services provided on the website?

Yes

No

Are you aware you can access your medical records, view test results and make appointments online?

Yes

No

Overall how satisfied are you with the service provided by Churchmere Medical Group? Please score on a scale of 1-5, where 1 = ‘Not’ and 5 = ‘Very’

1

2

3

4

5

If you could change one thing about the services provided what would it be?