Balance Street

Balance Street Health Centre
Patient Survey


We would be grateful if you could take the time to complete this survey with regard to the
Balance Street Practice Health Centre.

 

Title:
Full Name:
Email Address:
   
Gender:
Age Group:

1 How often have you visited the Health Centre in the past year?
     
2 Were all your visits to see a Doctor? Yes No
  If no, then please state what other service you used.
   
     
3 How did you book your appointment?
       
4 How easy was it to make the appointment?
Scale = Easy 1 2 3 4 5 Difficult
       
5 How would you rate the courtesy of the staff at the reception desk?
Scale = Very Courteous 1 2 3 4 5 Not Courteous
       
6 Are you satisfied with the current same day Appointment system?
If no, please state why
 Yes No
     
       
7 Would you be comfortable booking an Appointment online?
 Yes No
       
8 Do you smoke?
 Yes No
  If yes, how many a day?
       
9 Do you drink?
Yes No
  If yes, on average how many units do you drink a week?
I unit=half a pint, 2 units=1 pint or a small glass of wine or spirit
       
10 Are you aware of the services offered by Balance Street Health Centre?
 Yes No
  If no, then visit ‘H C Services’ at the top of the website page
       
11 How would you rate the overall service and care you receive from the Practice?
       
Do you have any other comments:

 

 

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Balance Street Health Centre - Telephone: 01889 562 145