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Feedback Form

Tell us how we are doing with our Patient Questionnaire

 

As we strive for excellence in Medical Laboratory testing, we would like to ask you to take a few moments of your time to comment on the service we provide, by completing this survey. Please tick the box which most closely describes your views and add any comments or suggests where appropriate.

 

Supplying your details is optional, however feel free to identify yourself or contact us so we can address any specific concerns you may have.

 

We appreciate your feedback. Thank you.

 

 

Collection Rooms
Date
Time
   
Were you able to find the collection rooms easily?
 
Easy to find Average Difficult to find    
   

RECEPTION

Were the instructions at reception easy to follow?

 
Easy Average Confusing    
   

WAITING

How long did you wait before you had your blood test?

 
Less than 5 minutes 5 - 10 minutes More than 10 mins More than 20 mins
   

How were the collection rooms?

 
Poor Good Excellent    
   
How would you rate the collection staff?
  Poor Good Excellent
Friendliness
Taking blood
Maintaining your privacy
Answering your questions
Professionalism
   

Would you have your blood test here again?

 
Yes No Don't Know    
If 'No', could you please comment?
   
Do you have any other comments you wish to make about our services?
 
   

Would you like

us to contact you?

Yes No        
Name

Address
Email
Phone
 

 

 

 

 
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