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Patient FFT Generic For Website

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Question 1.

So we can make sure your feedback reaches the right service, please can you help us identify which service you are reviewing?

*
Question 2.

We would like you to think about your experience of this service
Overall, how was your experience of our service?

- Required.
Question 3.

Thinking about the service we provide, please can you tell us why you gave your answer?

Question 4.

Please tell us about anything that we could have done better

Question 5.

Please put a tick in one of the boxes for each of the questions below

Were you treated with dignity and respect?
Were you involved as much as you wanted to be in your care and treatment?
Did you receive timely information about your care and treatment?
Were you treated with kindness and compassion by the staff looking after you?
Question 6.

What age are you?

Question 7.

Are you male or female

This is required
Question 8.

The person completing this form

Question 9.

Do you consider yourself to have a physical or mental health condition or disability?

Question 10.

What is your ethnic group?

White

Asian or Asian British

Mixed

Black or Black British

Other Ethnic Group