SurveyForm

Primrose Hospice Survey Form

We are so glad you decided to take this survey. Your feedback is central to continued improvement of our services so we can offer you and yours the quality of care you deserve.You will have the opportunity to give more detailed feedback further on in the survey. Click START to continue.

Primrose Hospice Survey Form

We are collecting and using data in accordance with the University of Leicester Privacy Notice (Website privacy policy). Please contact the Information Commissioner on 03031231113 if you have any concerns. If you would like to speak to one of the team at Primrose Hospice & Family Support Centre about your feedback in more detail please call us on 01527889799 or email info@primrosehospice.org. Click NEXT to choose the service that you received.

Which service did you access at Primrose Hospice?

Day Hospice

Occupational Therapist

Family Support

Physiotherapist

Children

Living Well Service

Counselling

Clinical Nurse Specialist

Benefits Advice

Section 1

Our Environment at Primrose Hospice

We will not ask you to identify yourself in the survey. To maintain the privacy of our staff we request you DO NOT IDENTIFY them by name. When answering questions, simply select the smiley that best describes your experience. Click NEXT to start answering the survey.

Primrose Hospice Survey Form

Section 2 Your Care at Primrose Hospice

Primrose Hospice Survey Form

Section 3 Our Staff at Primrose Hospice

13. Is there any positive feedback you would like to provide?

NOTE: Please DO NOT identify yourself or our staff

14. We are always looking for ways to improve. Are there any improvements, no matter how big or small, that you would like to suggest? This will help us deliver the best possible care and support.

NOTE: Please DO NOT identify yourself or our staff

Primrose Hospice Survey Form

Section 4 Finally...

15. Would you feel confident to make suggestions, complaints or feedback if you needed to?

16. How likely are you to recommend Primrose Hospice Services to people you know?

Primrose Hospice Survey Form

We are so glad you decided to take this survey. Your feedback is central to continued improvement of our services so we can offer you and yours the quality of care you deserve.You will have the opportunity to give more detailed feedback further on in the survey. Click START to continue.

Primrose Hospice Survey Form

Section 1

Our Environment at Primrose Hospice

We will not ask you to identify yourself in the survey. To maintain the privacy of our staff we request you DO NOT IDENTIFY them by name. When answering questions, simply select the smiley that best describes your experience. Click NEXT to start answering the survey.

Primrose Hospice Survey Form

Section 2

Your Care at Primrose Hospice

Primrose Hospice Survey Form

Section 3

Our Staff at Primrose Hospice

Primrose Hospice Survey Form

Section 4

Finally...

Confirmation