‘General Practice Out of Hours Service’ Available week nights and Saturdays.

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Which of the following best applies to you

I am answering these questions about myself

I am answering these questions on behalf of another patient

I am answering these questions on behalf of another patient as their carer

Which GP Practice are you or the person you are completing for registered at:

Hetton Group Practice

Herrington Medical Practice

Kepier Medical Practice

Houghton Medical Group

Grangewood Surgery

Westbourne Medical Group

What is your age

18-49

50-65

65-80

81+

What is your gender

Male

Female

Prefer not to say

Other (please specify):

This is required

Do you consider yourself to be disabled and if so what is the nature of your disability

Yes (Please specify)

Comments:

This is required

How far in advance would it be most useful for you to book appointments

Same day

Next day

Within a few days

More than a week and up to two weeks

Of all potential Enhanced Access appointment slots, which are your preferred time/s?

Weekday (7am-8am)

Weekday Evening (6:30pm – 8pm)

Saturday Morning (9am-1pm)

Saturday Afternoon (1pm-5pm)

Please select your preferred consultation type

Telephone

Video calls

Face-to-face appointment

Whichever is quicker

Mixture of the above

Depends on the issue to be dealt with

Which mode of transport do you use most often to get to your GP practice?

Car – drive yourself

Car – someone else driving

Public transport

Walking

Taxi

Don’t know/unsure

In minutes, how long does it normally take you to get to your GP practice using your most-used method of transport?

0 – 10 minutes

10 – 20 minutes

20 – 30 minutes

30 – 40 minutes

40+ minutes

‘General Practice Out of Hours Service’ Available week nights and Saturdays.

Which of the following best applies to you

Which GP Practice are you or the person you are completing for registered at:

What is your age

What is your gender

Do you consider yourself to be disabled and if so what is the nature of your disability

Please indicate how happy you would be to attend the following appointments at a different location to your usual practice, if it meant you could be seen faster:

How far in advance would it be most useful for you to book appointments

How likely are you to use additional appointments at the following times:

Of all potential Enhanced Access appointment slots, which are your preferred time/s?

If you were offered an appointment at another location at a convenient time, how long would you be prepared to travel/be able to travel for?

Please select your preferred consultation type

Please share more details on your views about the following methods of appointment consultations:
Please state how far you agree with the following statements:

Which mode of transport do you use most often to get to your GP practice?

In minutes, how long does it normally take you to get to your GP practice using your most-used method of transport?

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Which of the following best applies to you

Which GP Practice are you or the person you are completing for registered at:

What is your age

What is your gender

Do you consider yourself to be disabled and if so what is the nature of your disability

Please indicate how happy you would be to attend the following appointments at a different location to your usual practice, if it meant you could be seen faster:

How far in advance would it be most useful for you to book appointments

How likely are you to use additional appointments at the following times:

Of all potential Enhanced Access appointment slots, which are your preferred time/s?

If you were offered an appointment at another location at a convenient time, how long would you be prepared to travel/be able to travel for?

Please select your preferred consultation type

Please share more details on your views about the following methods of appointment consultations:Please state how far you agree with the following statements:

Which mode of transport do you use most often to get to your GP practice?

In minutes, how long does it normally take you to get to your GP practice using your most-used method of transport?

Please share more details on your views about the following methods of appointment consultations:
Please state how far you agree with the following statements: