Website Questionnaire Q4 2018/2019 Phlebotomy Service - Patient Satisfaction

Question Title

* 1. When were you seen at Chalfont and Gerrards Cross Community Hospital?

Date / Time

Date

Time

AM/PM

Question Title

* 2. Please could you rate the following aspects of our service:

	Excellent	Good	Satisfactory	Poor
The waiting time for an appointment in our clinic	The waiting time for an appointment in our clinic Excellent	The waiting time for an appointment in our clinic Good	The waiting time for an appointment in our clinic Satisfactory	The waiting time for an appointment in our clinic Poor
The appointment booking service	The appointment booking service Excellent	The appointment booking service Good	The appointment booking service Satisfactory	The appointment booking service Poor
The location of our clinic	The location of our clinic Excellent	The location of our clinic Good	The location of our clinic Satisfactory	The location of our clinic Poor
The speed at which you were seen on the appointment day	The speed at which you were seen on the appointment day Excellent	The speed at which you were seen on the appointment day Good	The speed at which you were seen on the appointment day Satisfactory	The speed at which you were seen on the appointment day Poor
The attitude of the clinic staff	The attitude of the clinic staff Excellent	The attitude of the clinic staff Good	The attitude of the clinic staff Satisfactory	The attitude of the clinic staff Poor
The explanation of your procedure	The explanation of your procedure Excellent	The explanation of your procedure Good	The explanation of your procedure Satisfactory	The explanation of your procedure Poor
Your confidence and trust in the phlebotomist in charge of your care	Your confidence and trust in the phlebotomist in charge of your care Excellent	Your confidence and trust in the phlebotomist in charge of your care Good	Your confidence and trust in the phlebotomist in charge of your care Satisfactory	Your confidence and trust in the phlebotomist in charge of your care Poor