Thank you for taking the time to complete this short survey, it should take you 2-5 minutes to complete and will help us improve our service for everyone.

* 2. Was this your first choice of transport?

* 3. What was the length of time between when you were referred and your appointment at the clinic?

* 4. Were you given clear information about the following?

* 5. Did you find the waiting room conditions comfortable?

* 7. Did you find that the healthcare staff you saw were...

  Yes, completely Yes, to some extent No
Helpful
Friendly
Respectful

* 8. Were you given any of the following information during your appointment?

  Yes No, but I would have liked it No, and I did not need it
An explanation of what the staff member was going to do
Details of any follow-up treatment or medicines
Information about how you can look after your eyes

* 9. Were any questions you had, answered in a satisfactory manner?

* 11. Were you given any printed information to take away with you?

* 13. If you would like to make any further comments about your visit to the clinic please do so below

* 14. When were you seen in the service?

Date
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