Riverside Clinic Endoscopy patient satisfaction survey 20/21

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* 1. Which procedure did you have?

Gastroscopy

Colonoscopy

Flexible Sigmoidoscopy

Gastroscopy and Colonoscopy

Gastroscopy and Flexible Sigmoidoscopy

Other

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* 2. Were you offered a choice of dates/times to have the test?

Yes

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* 3. Did you receive your pre-appointment preparation pack?

Yes

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* 4. Was the written information about what the test involved helpful?

Yes

If no, please comment

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* 5. Did you have any problems taking your bowel prep?

Yes

N/A

If yes, what were they and did you seek help?

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* 6. At the Reception, were you dealt with promptly and efficiently?

Yes

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* 7. Was there a delay on the day of your procedure?

Yes

Don't know

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* 8. If yes, were you informed of the reason?

Yes

N/A

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* 9. How would you rate the amount of information given to you by the nurse admitting you for the test?

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* 10. Did the nurse explain that there might be risks/complications associated with doing the test?

Yes

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* 11. Were you given an opportunity to ask questions before signing the Consent Form?

Yes

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* 12. Did the staff involved in your care introduce themselves to you?

Yes

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* 13. Did you opt for sedation on this occasion?

Yes

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* 14. How would you describe, if any, your pain during the procedure?

None

Mild

Moderate

Severe

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* 15. Were you given enough privacy when changing or being prepared for your procedure?

Yes

N/A

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* 16. Did you feel that your privacy/dignity was respected during the procedure?

Yes

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* 17. Did you feel that your privacy/dignity was respected whilst in recovery?

Yes

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* 18. Were the results to the test explained to you afterwards?

Yes

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* 19. Were you provided with a copy of the examination report?

Yes

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* 20. If you need to wait for histology results, was it made clear to you how you would get the results?

Yes

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* 21. Are there ways in which your visit to the endoscopy unit could have been improved?

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* 22. Is there anything you think the Endoscopy Unit is doing particularly well?

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* 23. How would you rate your overall experience in the Endoscopy Unit?

Excellent

Very Good

Good

Fair

Poor

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* 24. How likely are you to recommend Riverside Endoscopy to friends or family?

Extremely likely

Likely

Neither likely nor unlikely

Unlikely

Extremely unlikely

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* 25. We have many ways to feedback about your experience with us today. You can also tell us via NHS Choices, our website and by email. Please give your name and address ONLY if you would like a response to your comments

Name

Address

Email Address

Phone Number