Questionnaire – Minor Surgery

If you had minor surgery at The Quarter Jack Surgery in the past year, and have not already completed a feedback form, please submit your answers below.

Please give the month and year of your surgery:

Were you offered appropriate counselling and advice before your minor surgery?

Yes

Were you happy with the care you received at your appointment by the GP?

Yes

Were you happy with the care you received at your appointment by the nurse?

Yes

Did you have a follow-up appointment?

Yes

Do you have any feedback/comments that you would like us to consider?

If your comments need a reply, please give us your full name and contact details:

Finally, please could you tell us a little about yourself:

Age:

Gender:

Male

Female

Which ethnic group do you belong to?

White/White British

Black/Black British

Mixed

Chinese

Asian/Asian British

Other ethnic group

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