Patient feedback questionnaire Question Title * 1. Which age group are you in? Under 15 16–25 26–35 36–45 46–55 56–65 66–75 76+ Question Title * 2. Which GP practice are you registered with? Question Title * 3. What is your employment status?(This is relevant because we need to know whether people who work full-time are now finding it easier to access primary care appointments.) Employed – full time Employed – part time Self-employed Unemployed Retired Student Question Title * 4. How did you hear about the Improving Access service? (Please tick all that apply) GP practice website Through a phone call to my practice Banner/poster at my practice East Riding of Yorkshire CCG website Word of mouth At the hospital I have never heard of Improving Access services Other (please specify) Question Title * 5. What type of appointment did you have? GP Nurse Physiotherapist Pharmacist Healthcare Assistant Other (please specify) Question Title * 6. Did you require further follow up in your own practice after the Improving Access appointment? Yes, I needed a further appointment at my own practice No, my treatment was completed at the Improving Access appointment I was referred on to another service Other (please specify) To what extent do you agree with the following statements? Question Title * 7. I was satisfied with my experience of the Improving Access service Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 8. I could get an appointment at a time that suited me Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Any other comments Question Title * 9. The location of my appointment was convenient Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Question Title * 10. Do you have any other comments or feedback? Thank you for your time on behalf of East Riding of Yorkshire Federation of GP Federations. Find out more on our website: www.improvingaccess.org Done
