Risedale Surgery

Reception Customer Satisfaction Survey

Following your visit to the Surgery we want to be sure that you are satisfied with the outcome. Please take a moment to complete this short survey. Your feedback will be used to improve our service:-

Your responses will be kept confidential.

Please tick the appropriate box:

Male: □ Female: □ Age Range: 15-24, 25-34, 35-50, 51-74, 75+

Employed:□ Unemployed: □ Retired: □

Date Appointment: Time:

Can you mark on a scale 1 – 10 – 1 is disagree & 10 is strongly agree

1. Public Entrance is clearly marked 1 2 3 4 5 6 7 8 9 10

2. The environment is clean & tidy 1 2 3 4 5 6 7 8 9 10

3. I was treated with respect 1 2 3 4 5 6 7 8 9 10

4. The member of staff listened carefully to me 1 2 3 4 5 6 7 8 9 10

5. The member of staff was able to handle my problem/query quickly 1 2 3 4 5 6 7 8 9 10

6. I was satisfied with the way I was 1 2 3 4 5 6 7 8 9 10 handled.

Of all the answers above is there anything you strongly want to comment on? Please use the box below to do so.

Any other comments for future questionnaires?