<p> Risedale Surgery</p><p>Reception Customer Satisfaction Survey</p><p>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:-</p><p>Your responses will be kept confidential.</p><p>Please tick the appropriate box:</p><p>Male: □ Female: □ Age Range: 15-24, 25-34, 35-50, 51-74, 75+</p><p>Employed:□ Unemployed: □ Retired: □</p><p>Date Appointment: Time:</p><p>Can you mark on a scale 1 – 10 – 1 is disagree & 10 is strongly agree</p><p>1. Public Entrance is clearly marked 1 2 3 4 5 6 7 8 9 10</p><p>2. The environment is clean & tidy 1 2 3 4 5 6 7 8 9 10</p><p>3. I was treated with respect 1 2 3 4 5 6 7 8 9 10</p><p>4. The member of staff listened carefully to me 1 2 3 4 5 6 7 8 9 10</p><p>5. The member of staff was able to handle my problem/query quickly 1 2 3 4 5 6 7 8 9 10</p><p>6. I was satisfied with the way I was 1 2 3 4 5 6 7 8 9 10 handled.</p><p>Of all the answers above is there anything you strongly want to comment on? Please use the box below to do so.</p><p>Any other comments for future questionnaires?</p>