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Home
About Us
Practice Information
Our Doctors
Fees
Privacy Policy
Services
After-Hours Medical Care
Services Offered
Appointments
Make Appointments
New Patients
Contact Us
News
Patient Experience Questionnaire
Q1. Making an appointment and waiting to see a clinician at your last visit (please rate each statement)
a) The time you had to wait to get this appointment (before getting to the clinic)
Poor
Fair
Good
Very Good
Excellent
N/A
Don't Know
b) The time you had to wait after you arrived at the clinic
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Getting reminders for your appointment
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about making an appointment and waiting to see a clinician?
Q2. Your experience with reception staff at your last visit (please rate each statement)
a) Were welcoming upon your arrival
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Considered your needs when making an appointment
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Were courteous and polite
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about your experience with reception staff at your last visit?
Q3. Your experience of the interpersonal skills of the clinician at your last visit (please rate each statement)
a) Had enough time to talk about the things that were important for you
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Showed sensitivity to your concerns
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Understood your personal circumstances
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about you experience with clinical staff at your last visit?
Q4. Your experience of the way clinicians communicated with you at your last visit (please rate each statement)
a) Helped you understand your medical condition
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Explained the purpose of tests and treatment
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Involved you in decisions
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about the way clinicians communicated with you at your last visit?
Q5. Your experience of the information given to you by your clinicians at your last visit (please rate each statement)
a) The amount of useful information given about your condition
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Gave you useful written information
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Told you where to find reliable information on the internat
Poor
Fair
Good
Very Goo
Excellent
N/A
Don't know
d) Information about how to prevent future health problems
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about the information given to you by clinicians at your last visit?
Q6. Your experience of privacy at your last visit (please rate each statement)
a) Privacy when you were examined
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Being able to discuss personal issues that were sensitive
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Your understanding of how medical records are kept private in the clinic
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about your experience of privacy at your last visit?
Q7. Your experience of the way your clinician worked with other healthcare professionals at your last visit (please rate each statement)
a) Knew your medical history at the clinic
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Gave you options for specialists or other health providers you need to see
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
c) Allowed you to have the final choice about which other professionals to see
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about the way your clinician worked with other healthcare professionals at your last visit?
Q8. Thinking about your experience with the general practice over the past year (please rate each statement)
a) Being able to see the doctor of your choice
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
b) Being able to see a doctor at the clinic when you needed urgent care
Poor
Fair
Good
Very Goo
Excellent
N/A
Don't know
c) Suitability of clinic opening hours
Poor
Fair
Good
Very Good
Excellent
N/A
Don't know
Do you have any comments you would like to make about your experience with the general practice over the last year?
Q9. If you could change one thing about the practice, what would you change?
Please write your ideas below:
Some things about you
Are you?
Male
Female
Have you been to another general practice in the last year?
Yes
No
What is your age?
15 - 24 years
25 - 44 years
45 - 64 years
65 years or over
Don't wish to say
How long have you been coming to this practice?
Less than 1 year
1 - 2 years
3 years or more
Not sure
How many times have you visited this practice over the past 12 months?
Only this visit
2 - 5
6 - 10
11 or more
Not sure
Was this visit for yourself or someone you are caring for?
Self
Someone else
Do you consider yourself to be of Aboriginal and/or Torres Strait Islander descent?
Yes
No
Which languages do you speak at home? (Tick all spoken)
English
Arabic
Cantonese
Mandarin
Vietnamese
Hindi
Greek
Other
Do you have any of these concession cards?
Health Care Card
Pensioner Concession Card
Any Veterans' Affairs treatment card
Not covered by any concession card
What is the highest level of education you have reached?
Some high school
Completed high school
Currently studying for a higher degree
Completed a trade or technical qualification
Completed a degree or diploma
Postgraduate degree
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