Patient Satisfaction Questionaire

Dear Patients

It is important to this practice that we provide you, our patient, with a quality health service. Would you please take the time to fill out this anonymous survey about our practice so that we can identify areas in which we can better meet your needs?

How would you rate your experience with this practice?

Please answer the following questionnaire to provide us with your personal feedback

Availability of longer consultations

Having the urgency of my needs determined promptly when telephoning the practice

Obtaining information or advice about your treatments by telephone or electronic means when a consultation is not necessary or practical

Arrangements for medical care outside our practices normal opening hours

Receiving sufficient information about the purpose, importance, benefits and risks of proposed treatments/procedures proposed by the Doctor for you to make an informed decision about your treatment/procedures

Being informed of costs before treatments, investigations or procedures performed by our practice in addition to the consultation cost

The doctors discuss health promotion or disease prevention with you

Do you feel that you are being treated respectfully by the doctor and staff

The way in which the practice handles complaints and feedback that you may give to them

The practice obtains my permission before a consultation if there is ever a third person invited to be present in my consultation (e.g. a medical student, another staff member or a family member)

Ease of contacting the practice by telephone

Satisfaction with the facilities in the consulting area(s)

The way in which the practice makes adequate provisions for your privacy

Satisfaction with your treatment/procedure

Would you recommend Lavida Cosmetic Medicine’s products and services to your family and friends?

I am

What is your age range

How long have you attended this practice

The name of my Doctor / Therapist is

Today\'s date

Are there any other comments you would like to make about our practice, doctors and staff

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Cosmetic Physicians

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