Please tick one answer for each question.
Dear Patient, we would be grateful if you would complete this questionnaire about your visit to the doctor today. The doctor that you have seen is a fully qualified doctor who is learning to become a general practitioner. Feedback from this survey will enable them to identify areas that may need improvement. Your opinions are therefore very valuable.
Please answer all the questions below. There are no right or wrong answers and your doctor will not be able to identify your individual responses.
Can we ask that your response is regarding the doctor named above only and that you do not write any names (either yourself or any members of staff).
Did this doctor make you feel relaxed and welcome?
Do you feel this doctor listened to you?
Did the doctor explain things to you in a way you could understand?
Were you involved as much as you wanted to be in decisions about your care and treatment?
Do you have confidence in the decisions made about your condition or treatment?
Do you know what will happen next with your care?
Do you know what to do if your condition gets worse?
Did the doctor treat you with respect and dignity?
Do you trust this doctor?
Do you have any specific comments about this doctor from this consultation?