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.

Was this your first choice of transport?

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* 2. Was this your first choice of transport?

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

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

Were you given clear information about the following?

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

Did you find the waiting room conditions comfortable?

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

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

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

  Yes, completely Yes, to some extent No
Helpful
Friendly
Respectful
Were you given any of the following information during your appointment?

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

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

Were you given any printed information to take away with you?

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

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

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

When were you seen in the service?

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* 14. When were you seen in the service?

Date

T