0198 Audiology Satisfaction Questionnaire General Online Forms Current User: Not Logged In
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Audiology Satisfaction Questionnaire
General
We are writing to you because you were recently seen in the Audiology department. We hope that you are satisfied with the service that you received from us and would value your feedback so that we can evaluate the service we provide and make any necessary improvements. If you are happy to do so please complete this form and return it to us in the envelope provided, please note that all feedback received will be completely anonymous unless you choose to leave your contact details.

If you are having problems with your hearing aids and would like to be seen please phone us on 01803 656325 to make an appointment

This information can be made available in other formats. If you need it in: Large print, Braille, Audio, a language other than English, Total Communication format (for people with a learning difficulty), or if you have any concerns or queries regarding this questionnaire please contact us on the above number.

Please indicate your satisfaction with various aspects of our service by ticking the answer which most applies to you. If there are any questions that do not apply or that you cannot remember the answer to please leave these blank.
1) The department was easy to get in touch with
(Only answer this question if you contacted us to
make the appointment)
2) I was satisfied with the length of time I waited
for my appointment
3) I was satisfied with the length of time I waited
on the day of my appointment
4) The appointment was convenient for me to
get to
5) Reception staff were friendly and helpful
6) The waiting area was comfortable and clean
7) The treatment room was comfortable and clean
8) Audiology staff were friendly and helpful
9) Audiology staff were caring and listened to my
concerns
10) My specific problems and needs were addressed
11) I had opportunities to ask questions
throughout my appointment
Strongly
agree
Agree
Neither agree
nor disagree
Disagree
Strongly
disagree