About You

Are you:
 Male Female

Your age group:
 Under 20  21-35  36-50  51-65  66 +

Telephone Contact

How would you rate the following?

Someone answers your call within a reasonable length of time.
 Poor  Fair  Good  Excellent  Not applicable

The telephone manner and helpfulness of the staff
 Poor  Fair  Good  Excellent  Not applicable

On Arrival

How would you rate:

The staff in terms of helpfulness and politeness?
 Poor  Fair  Good  Excellent

The standard of the waiting room and amenities?
 Poor  Fair  Good  Excellent

If there are any facilities/amenities that you think would have
improved your visit please list them below.

Quality

Were you seen on time?
 Yes  No

If no, how long did you have to wait?
 Under 15 mins  16-30 mins  31-45 mins  Over 46 mins  Not applicable

Overall, how would you rate the service you received from:

Our administrative staff?
 Poor  Fair  Good  Excellent  Not applicable

The consultant?
 Poor  Fair  Good  Excellent  Not applicable

Did you feel the consultant fully understood your concerns?
 Poor  Fair  Good  Excellent  Not applicable

Were you shown respect for your dignity and privacy?
 Poor  Fair  Good  Excellent  Not applicable

Is there anything we could do to make visiting the Clinic a
better experience? (optional)

Would you recommend the Sports Injury Diagnosis Clinic to family and friends?
 Yes  No

If no, please state why:

 
Type the letters or numbers in the above image.