Montier Health Benowa: Feedback Form

Montier Health Benowa values patient feedback.

We would love to know your feedback on your recent experience in our clinic.

First Name *

Last Name *

Email Address

Phone:

About Your Visit

What type of appointment did you attend? *

GP ConsultationNurse AppointmentProcedure AppointmentFollow-up AppointmentResults Appointment

Was this your first visit to our practice? *

YesNo

Appointment and Access

How easy was it to book your appointment *

Very EasyEasyNeutralDifficultVery Difficult

How satisfied were you with the appointment availability? *

Extremely SatisfiedSatisfiedNeutralDissatisfiesExtremely Dissatisfied

How long did you wait for your appointment? *

On TimeLess 10 minutes10-20 minutesMore than 20 minutes

Our Team

Reception staff were courteous and helpful *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The clinician (doctor/ nurse) listened carefully to my concerns *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

I felt respected and treated with dignity *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The clinician explained my condition and treatment clearly *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

Care and Experience

I felt confident in the care I received *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

The practice environment was clean and comfortable *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

My privacy and confidentiality were respected *

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree

Overall Satisfaction

Overall, how satisfied were you with your visit? *

Extremely SatisfiedSatisfiedNeutralDissatisfiedExtremely Dissatisfied

How likely are you to recommend our practice to family or friends? *

Very LikelyLikelyNeutralUnlikelyVery Unlikely

Open Feedback

What did we do well during your appointment? *

Is there anything we could improve? *

Any additional comments or suggestions? *

Would you be happy for us to contact you about your feedback?

YesNo

If yes, preferred method of contact?

PhoneEmail

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