Leave Feedback We continually strive to improve our care to patients. Please help us by giving feedback regarding your experience with Wimbledon NeuroCare. You can do this by filling in our online form below. Thank you for your time, your opinions are important. Patient Feedback Form Who did you book your appointment with? * Wimbledon NeuroCare OfficeThe Hospital Reception Others: * How easy was it to book your appointment? * (1 = not easy, 5 = very easy) 1 - Not at all easy2 - Not very easy3 - Average4 - Fairly easy5 - Very easy How was the service you received from Wimbledon Neurocare staff? * (1 = very poor, 5 = excellent) 1 - Very poor2 - Poor3 - Average4 - Good5 - Excellent How was the service you received from Hospital staff? * (1 = very poor, 5 = excellent) 1 - Very poor2 - Poor3 - Average4 - Good5 - Excellent How long did you wait to be seen? * Seen on timeUnder 10 mins10 - 20 mins20 - 30 minsOver 30 mins How was your appointment * (1 = very poor, 5 = excellent) 1 - Very poor2 - Poor3 - Average4 - Good5 - Excellent Appointment details Date: * Location: * Nuffield Parkside HospitalWimpole St ClinicSpire St Anthony’s HospitalSpire Clare Park HospitalNuffield GuildfordNew Malden Diagnostic Centre Appointment Type: * ConsultationPhysiotherapyEMG/Nerve conductionEEGCognitive AssessmentAudiovestibular Testing Consultant: Dr Mushriq Al-KhayattDr Hamid ModarresDr Borka CeranicDr Charlotte AgrupDr Sarah GriffithsDr Nofal KhalilSharon Berger-CollinsDr Claire O’NeillJohn Veness Did you feel that you were treated with dignity and respect? * YesNo Would you recommend Wimbledon NeuroCare to others? * YesNo How can we improve your experience? Any other comments? How did you hear about Wimbledon Neurocare? GP / Healthcare professional referralGoogle searchSocial media (e.g. Instagram, LinkedIn)Wimbledon Neurocare websiteOnline review (e.g. Doctify, Google Reviews)Private health insurance providerOther (please specify) Keeping your feedback confidential This survey is confidential, however, please complete your contact details if you would like us to call to discuss your comments. Feedback will be reviewed every six months, but your name will never be disclosed with the results. Contact details Name: * Email: * Telephone: * Please leave this field empty. Thank you for your time
