Patient Feedback Sign Up Patient Satisfaction Survey Name First Last Section 1: Satisfaction with Current Opening HoursHow satisfied are you with our current opening hours? Very Satisfied Optional Satisfied Optional Neutral Optional Dissatisfied Optional Very Dissatisfied Optional Do you feel our opening hours suit your needs?Do you feel our opening hours suit your needs? Yes, Competely Optional Somewhat Optional No, Not at all Optional 3. If dissatisfied, please share why our current opening hours do not meet your needs. (Open-ended) OptionalSection 2: Convenient Appointment Times4. Which of the following times are most convenient for you to book an appointment?(Select all that apply) 6.30am – 8.00am Optional 8.00am – 10.00am Optional 10.00am – 12.00pm Optional 12.00pm – 2.00pm Optional 2.00 – 4.00pm Optional 4.00pm – 6.30pm Optional Section 2: Convenient Appointment Times5. Would you prefer more early morning appointments (6:30 am – 8:00 am)? Yes Optional No Optional Not Sure Optional Section 2: Convenient Appointment Times6. Would you prefer more late afternoon appointments (6:00 pm – 8:00 pm)? Yes Optional No Optional Not Sure Optional Section 2: Convenient Appointment Times7. Would you prefer more late afternoon appointments (6:00 pm – 8:00 pm)? Yes Optional No Optional Not Sure Optional Section 2: Convenient Appointment Times8. Are you aware that you can pre-book a variety of appointments with different clinicians through our website’s ‘Book Appointment’ feature? Yes Optional No Optional Not Sure Optional 7. Do you have any suggestions on how we can improve our opening hours or appointment scheduling? (Open-ended) Optional
