AJM Healthcare - Service User Satisfaction Survey - 2021

1. Service user satisfaction feedback survey

At AJM, we are committed to improving the wheelchair services we provide.  To do this, we need your feedback.  In completing this questionnaire, you might like to consider the relevant items from the following list:
  • Appointment booking process
  • Timing of the appointment
  • Waiting time to be seen and to receive your equipment
  • Quality of work completed
  • Whether you received the care, service or information you needed
  • Support and training given about the use of equipment
  • If the needs of your carer or personal assistant were met
  • Whether the equipment helped your posture and/or level of independence
  • PWB (personal wheelchair budgets): whether you were informed about this NHS scheme
Questions marked with an * are mandatory.  This is a secure website; AJM Healthcare will not disclose any of your information to any third party and will treat all the information provided in the strictest of confidence.
 
 

1. In which CCG (Clinical Commissioning Group) area do you live?

 

2. What was the service user's age bracket at the time of the appointment (choose one)? *

 

3. Who are you (choose one)? *

 

4. What was the date of your appointment? *

   DD/MM/YYYY 
 
 

5. What was the name of the staff member you saw?

 

6. What was the reason for your appointment (choose the one which fits best)? *

 

7. NHS Friends and Family test: overall, how was your experience of our service? *

 

8. General questions *

Yes, definitelyTo some extentNo
Did staff treat you or the person you supported with dignity and respect?
Did they talk to you or the person you supported in a way you/they could understand?
Did they listen to you/the person you supported?
 

9. What did the wheelchair service do well? *

 

10. How could we improve the service? *

 

Can we share your comments publicly? *

 

How was this survey completed? *

 

Thank you for taking the time to complete this survey; your feedback will be used to develop our services. If you would like us to review your individual case, please provide your:

 

We might not have asked everything you wanted. If so, please call us or email hello@wheelchair.services

Please consider joining one of our service user forums. If you would like to find out more, please provide your email address: