Customer Satisfaction Survey Template Kings College Hospital Occupational Health Department Patient Satisfaction Survey OK Question Title * 1. Reason for Visit Pre-Employment Screening Vaccination Doctor's Appointment Nurse Appointment Physiotherapist Occupational Therapist Walk-in Please specify employer: KCL, KCH, Medirest, ISS, Other( please specify) OK Question Title * 2. Overall, how easy do you find it to schedule appointments? Extremely easy Very easy Somewhat easy Not so easy Not at all easy Comments: OK Question Title * 3. The reception staff are friendly and approachable Extremely friendly Very friendly Somewhat friendly Not so friendly Not at all friendly Comments OK Question Title * 4. The waiting area and the consultation room were comfortable and tidy Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Other (please specify) OK Question Title * 5. My appointment was on time Yes No I was late for my appointment therefore it was rescheduled If you were delayed how long by? OK Question Title * 6. The Doctor/Nurse/Therapist treated me in a pleasant/professional manner Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Comments OK Question Title * 7. The Doctor/Nurse/ Therapist gave me good advice about my health, listened to me & acknowledged my concerns. Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree Comments: OK Question Title * 8. In future, I would consider returning to Occupational Health for advice and/or treatment for physical or psychological symptoms Very likely Likely Neither likely nor unlikely Unlikely Very unlikely Comments: OK Question Title * 9. Overall, how satisfied or dissatisfied are you with the Kings OH Service? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied Comments OK Question Title * 10. Do you have any other comments, questions, or concerns? OK DONE