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Completion Errors
Patient Experience
Questionnaire
Response Type :
Emergency Dept / MIU
Inpatient
Outpatient
Community
Service:
Location:
Date of discharge or attendance:
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Your feedback is important - it helps us to review and improve the services we provide.

We would like you to think about your experience of the service you have received, and take a moment to answer the following questions:
Overall, how was your experience
of our service?
Very good
Good
Neither good nor poor
Poor
Very poor
Don't know
Please can you tell us why your gave your answer?
What one thing could we have done better?
Please tell us what you, your family members and carers think should always happen when you use
our services:
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