0198 Audiology Satisfaction Questionnaire Remote Consultation Online Forms Current User: Not Logged In
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Audiology Satisfaction Questionnaire
- Remote Consultation
We are writing to you because you have recently taken part in a remote service appointment (Telephone or Video call) with 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 change in service that 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 selecting the answer which most applies to you.
1) The Audiologist explained everything to
me clearly in a way that I could understand
2) The appointment was arranged at a time
that was convenient for me
3) Based on my experience I would be
happy to use the remote consultation
service again (either telephone or video call)
4) I found the Audiology staff were friendly
and helpful
5) I found the Audiology staff were
caring and listened to my concerns
Strongly
Agree
Agree
Neither Agree
Nor Disagree
Disagree
Strongly
Disagree
Don't Know
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