General Practice Assessment Questionnaire

Dear Patient,

We would be grateful if you would complete this survey about your general practice and your most recent visit.

The doctors at your practice want to provide the highest standard of care. Feedback from this survey will enable them to identify areas that may need improvement. Your opinions are therefore very valuable.

Please answer ALL the questions that apply to you. There are no right or wrong answers and your doctor will NOT be able to identify your individual responses.

(This questionnaire should take you no more than 5 minutes to complete)

1General Practice Assessment Questionnaire

2Thinking of times when you want to see a particular doctor:

3Thinking of times you have phoned the practice, how do you rate the following:

4This question asks about your usual doctor. If you don't have a 'usual doctor', answer about the one doctor at your practice who you know best. If you don't know any of the doctors, go straight to question 10

5Thinking about your most recent consultation with the doctor, how do you rate the following:

6After seeing the doctor today or at your last consultation do you feel...

7Finally, it will help us to understand your answers if you could tell us a little about yourself:

if other, please describe below

8We are interested in any other comments you may have. Please write them here


Privacy Protection

Information entered into practice survey forms is used only for the purposes of processing your Survey information and is stored and accessed securely by designated Practice staff.

Issues raised in comments may be discussed between relevant members of the Practice. The information is used for quality monitoring purposes, in line with the expectations of the patients submitting the feedback.

Any personal information transmitted via Practice Survey forms may be anonymised by the Practice when this is required to ensure compliance with General Data Protection Regulation.

This information is not shared with any external third party organisations.

This information is kept for as long as the site is active or it is deleted by a site administrator.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.


Your Neighbourhood Professionals. Just a Click Away! Need advice on your pension? Want to avoid unwanted tax implications? Contact a local financial adviser today Digitone hearing Co Gorselands Nursing Home Parley Cross Pharmacy Penn Lawnmowers Brook View Nursing Home
Ferndown Medical Centre, St Mary’s Road Dorset, Ferndown, Dorset, BH22 9HF
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Your Neighbourhood Professionals. Just a Click Away! Need advice on your pension? Want to avoid unwanted tax implications? Contact a local financial adviser today Digitone hearing Co Gorselands Nursing Home Parley Cross Pharmacy Penn Lawnmowers Brook View Nursing Home
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