SWB Audiology Patient Experience Questionnaire (QR code)

Your feedback is important to us! Please take a few moments to complete this questionnaire about your recent experience of our Audiology service. All questions marked with an * require a response.

If you have a complaint/ suggestion you wish to discuss further with us, please email: swb-tr.audiology@nhs.net and enter Audiology Patient Group in the subject box.
 

1. Are you completing this questionnaire for : *

 

2. Was your appointment via: *

 

3. If your appointment was face-to face, at which location were you seen? *

 

4. What type of appointment did you attend? *

 

5. How satisfied were you with the choice of appointment date, time and location (if applicable)? *

 

6. Were you made to feel welcome? This can include telephone conversations and email correspondence. *

 

7. How satisfied were you with the way the clinician communicated with you at your appointment including the explanation of any test results and the options available to you? *

 

8. How satisfied were you with any written information you received, including appointment letters? *

 

9. How likely are you to recommend this centre/ service to your friends and family if they needed similar care or treatment? *

 

10. Do you have any suggestions you would like to make that would improve the service we currently offer to you?

 

11. Please state your/ the patient's age:

 

12. Please state your/ the patient's Ethnic Origin:

  • White
  • Asian or Asian British
  • Mixed
  • Black or Black British
  • Other Ethnic Group
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