Minor Procedures Feedback Survey

This questionnaire is designed to gather feedback from patients following minor surgery or procedures such as joint injections. This information will be used to inform our doctors and nurses.

Minor Procedures Feedback Survey

Please tell us who performed your procedure: *

Procedure and Date

Please choose the type of surgery or procedure that you have had with our service: *

Satisfaction of the Procedure on the Day

Please rate your satisfaction with the following:
Convenience of Appointment:
Consent Process and opportunity to ask questions:
Facilities & Hygiene:
Care given by clinician and/or operating assistant:
Post-procedural advice:
Post procedural follow up appointment (if applicable):

Satisfaction After, and Presence of Complications

How satisfied are you with the effect of treatment for the presented problem?
Please rate any potential complications from the procedure:
Post procedure pain:
Bleeding or bruising:
Scarring:
Post procedure wound infection:
Recurrence of initial problem:

Improving our Service