1 In the past 12 months how many times have you seen at the surgery?


2 How helpful do you find our surgery receptionists?


3 How do you rate our current opening hours, including our evening commuter surgeries?


4 Are you registered for our ON-LINE services?


4a How do you rate the Online Appointments?


4b How do you rate the Online Repeat prescriptions?


5 How quickly do you ususally get to be seen ?


5a If you need to be seen urgently, can you normally get an appointment on the same day?


5b How long do you usually have to wait for your consultation to begin?


5c Thinking of the times you have phoned the practice, how do you rate the following:

Ability to get through to the practice on the phone?


Ability to speak to a doctor/nurse on the phone when you need medical advice?


6 On a scale of 1 - 5 how important to you health and well being was your reason for visiting the doctor / nurse today?

Not very important Very Important


7 How good was your consultation today at each of the following (please tick one box on each line)

7a Being polite


7b Making you feel at ease?


7c Listening to you?


7d Assessing your medical condition?


7e Explaining your condition and treatment?


7f Involving you in decisions about your treatment?


7g Providing or arranging treatment for you?


8 Please decide how strongly you agree or disagree with the following statements by ticking one box in each line?

8a Keeps information about me confidential?


8b Is honest and trustworth?


8c Values continuity of my care by seeing the same doctor?


9 I am confident about this surgery's ability to provide care?


10 I would be completely happy to be seen again?


11 If you answered Poor or a low score to any of the questions, please give a reason

It will help us to understand your answers if you could tell us a little about yourself

13 Are you ?


14 How old are you?


15 Do you have a long-standing health condition or disability?


16 What is your ethnic group?


17Which of the following best describes you?


18 We are interested in any other comments you may have such as anything particularly good about Holbrook Surgery, anything that can be improved or any other comments.

Please write them here

Holbrook Surgery has an active Patient Participation Group (PPG) that helps provide a important communication link between the practice and our patients, supplying information on future plans, healthcare and involvement in patient surveys. If you would like to participate in our PPG please look on the PPG page of this website.