Patient Questionnaire 2016

Patient Questionnaire
1. Are you a registered patient at The Doctors’ House or The Hurley Surgery?
2. If you need to see a GP where do you usually go?
3. How many times have you used The Hurley Surgery in the past year?
4. If you have had an appointment at The Hurley Surgery, has the GP asked you to attend The Doctors’ House, Marlow for further investigations or tests?
5. If The Marlow Medical Group closes The Hurley Surgery, would you register with another practice or prefer to stay registered with The Marlow Medical Group?
6. Do you have a disability which means you have / would have difficulty accessing services at The Marlow Medical Group?

Personal Details

We would be grateful if you would provide the following information – it will help us know if we have received responses from a representative group of people.

Age Range
Gender
Ethnicity
Do you consider yourself to have a disability?
Please include your name, address, email address and telephone number.
Sending