Name

Email Address

1) How easy was your booking/admin process? (score 1 not at all easy to 5 extremely easy) 1) How easy was your booking/admin process? (score 1 not at all easy to 5 extremely easy) 1 (not at all easy) 2 3 4 5 (extremely Easy)

2) How easy was it to find an appointment time which suited you? (score 1 not at all easy to 5 extremely easy) 2) How easy was it to find an appointment time which suited you? (score 1 not at all easy to 5 extremely easy) 1 (not at all easy) 2 3 4 5 (extremely Easy)

3) How easy was it to find directions to the clinic? (score 1 not at all easy to 5 extremely easy) 3) How easy was it to find directions to the clinic? (score 1 not at all easy to 5 extremely easy) 1 (not at all easy) 2 3 4 5 (extremely Easy)

4) Was it possible to park in one of the clinics spaces? 4) Was it possible to park in one of the clinics spaces? Yes No

5) Was your treatment given on time? 5) Was your treatment given on time? Yes No

6) How well did you understand the explanation of your diagnosis? (score 1 I didn’t understand it to 5 I understood very clearly) 6) How well did you understand the explanation of your diagnosis? (score 1 I didn’t understand it to 5 I understood very clearly) 1 (I didn’t understand) 2 3 4 5 (I understood very clearly)

7) How well did you understand the explanation of your treatment? (score 1 I didn’t understand it to 5 I understood very clearly) 7) How well did you understand the explanation of your treatment? (score 1 I didn’t understand it to 5 I understood very clearly) 1 (I didn’t understand) 2 3 4 5 (I understood very clearly)

8) How effective do you feel your treatment was? (score 1 not effective at all to 5 extremely effective) 8) How effective do you feel your treatment was? (score 1 not effective at all to 5 extremely effective) 1 (not effective at all) 2 3 4 5 (extremely effective)

9) Do you feel the advice/exercises given were clear? 9) Do you feel the advice/exercises given were clear? Yes No

10) How likely are you to recommend our clinic to colleagues, family or friends? (score 1 not likely to 5 extremely likely) 10) How likely are you to recommend our clinic to colleagues, family or friends? (score 1 not likely to 5 extremely likely) 1 (not likely) 2 3 4 5 (extremely likely)

Q 11) How did you hear about us?

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