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We would be grateful if you would complete this feedback form following your recent visit to our clinic.

We aim to deliver complete patient satisfaction, collecting and acting on our patient feedback is vital to our achieving this; your opinions are therefore very valuable.                                

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* 1. How likely are you to recommend our clinic to friends or family if they needed similar care or treatment? Please select one of the following options:

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* 2. Were you treated with courtesy throughout your appointment(s) by administration staff and the health professionals?

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* 3. Were you involved as much as you wanted to be in decisions about your care and treatment?

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* 4. Was the explanation given by the health professional clear and easy to understand?

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* 5. How much information about your condition or treatment was given to you?

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* 6. Finally, we would be grateful for any of your own comments regarding the treatment you received, the service as a whole or any part of it.

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* 7. Date of your appointment

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* 8. Name of doctor

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