Reception Customer Satisfaction Survey
Reception Customer Satisfaction Survey
Following your visit to the Surgery we want to be sure that you are satisfied with the outcome. Please take a moment to complete this short survey. Your feedback will be used to improve our service:-
Your responses will be kept confidential.
Please tick the appropriate box:
Male: □ Female: □ Age Range: 15-24, 25-34, 35-50, 51-74, 75+
Employed: □ Unemployed: □ Retired: □
Date Appointment: Time:
Can you mark on a scale 1 – 10 – 1 is disagree & 10 is strongly agree
1. Public Entrance is clearly marked 1 2 3 4 5 6 7 8 9 10
2. The environment is clean & tidy 1 2 3 4 5 6 7 8 9 10
3. I was treated with respect 1 2 3 4 5 6 7 8 9 10
4. The member of staff listened
carefully to me 1 2 3 4 5 6 7 8 9 10
5. The member of staff was able to
handle my problem/query quickly 1 2 3 4 5 6 7 8 9 10
6. I was satisfied with the way I was 1 2 3 4 5 6 7 8 9 10
handled.
Of all the answers above is there anything you strongly want to comment on? Please use the box below to do so.
Any other comments for future questionnaires?
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