For all patients having their medication dispensed either at Wellesbourne or Kineton Surgery

In order to find out how we are meeting your needs, we are asking our patients a few questions about the care they have received.  Please be honest in your answers.  Your comments will be held in strict confidence and you do not have to sign your name unless you want to.  We plan to use your suggestions to make our service to you and your family even better.  Thank you for your comments.

How many times do you visit our dispensary

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* 1. How many times do you visit our dispensary

How do you order your repeat prescription?

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* 2. How do you order your repeat prescription?

Overall, how would you rate the quality of your customer service experience?

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* 3. Overall, how would you rate the quality of your customer service experience?

How well did we understand your questions and concerns?

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* 4. How well did we understand your questions and concerns?

Where do you have your medication dispensed?

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* 5. Where do you have your medication dispensed?

Please tick all the services that you know are currently available to you

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* 6. Please tick all the services that you know are currently available to you

Do you have any suggestions, comments or questions?

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* 7. Do you have any suggestions, comments or questions?

What are we doing well?

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* 8. What are we doing well?

Please could you confirm your age

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* 9. Please could you confirm your age

Gender:

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* 10. Gender:

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