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Young Person's Questionnaire

For ages 16 to 25

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Thank you for taking the time to complete this survey.

Please be reassured that it is completely anonymous.
We value your input as a young person using our service and would welcome advice on how we can improve your experience at the end of the survey.

Initial Questions

Did you attend on you own?: *

Did you feel that your concerns were heard and your questions were answered by the clinician (ie doctor or nurse) ?: *

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Making Appointments

If you need to make an appointment, who makes that appointment for you: *

If you do not make your own appointments, please could you explain why?: *

How do you prefer to make an appointment?: *

What type of appointment do you prefer?: *

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Confidentiality

Did you know that seeing or speaking with anyone in the surgery is confidential?: *

All information given to the practice is confidential and we will not discuss your medical records with anyone without your permission.

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Social Media

Is the information on the website easy to find: *

Do you think there should be additional information?: *

What media platform would you prefer to use to access healthcare information: *

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General Question

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This form collects personal and medical information about you and we use this information to allow the practice team to contact you.
Please read our Privacy Policy to discover how we protect and manage your submitted data.

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