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Patient survey for Dr Heather Ryan

All Licensed doctors are expected to seek feedback from colleagues and patients. It is expected of Health professionals to seek feedback from colleagues and patients. They should then review and act upon that feedback where appropriate.

We are asking you to complete this form so that you can let the doctor know what you think about the care they have given you today (or your most recent consultation). The doctor involved can then take this away, and think about any improvements or adjustment they may need to make so that they can care for you, and other patients, better in the future.

We only want to know about what happened to you today (or your most recent consultation), not your general experience of this doctor.

It is important that these forms are anonymous, so please do not write your name anywhere on the sheets.

If you are completing the form on behalf of someone else please answer the questions from the patient's point of view.

Question 1.

Are you completing this form as

Question 2.

Please can you tell us your gender

Question 3.

Please can you tell us your age

Question 4.

Have you had contact with this doctor before?

Question 5.

How welcome and relaxed did the doctor make you feel?

Question 6.

How much did the doctor involve you in decisions during the consultation?

Question 7.

Did you feel the doctor listened to you?

Question 8.

Did you feel confident that the doctor's clinical knowledge was good?

Question 9.

Did you feel confident about the doctor's assessment?

Question 10.

Did you feel the doctor addressed all of your concerns?

Question 11.

Are you clear about what will happen next?

Question 12.

Do you know what to do if your condition gets worse?

Question 13.

How good did you feel the doctor was at caring for you?

Question 14.

How easy did you find it to understand what this doctor was telling you?

Question 15.

How confident are you that this doctor will keep information about you confidential?

Question 16.

How confident are you that this doctor is honest and trustworthy?

Question 17.

If you are happy to, please can you tell us your ethnicity?

Question 18.

Any other general comments