Feedback

To help provide the best quality of care to all our patients please could you help us by completing the following feedback form.

1. Where did you hear about us?


 


 

3. Did you attend any NHS outpatient appointments for fertility investigations at the Princess Anne Hospital?

please go to question 4

 

3a. How long did you have to wait for your first appointment?

 

3b. How well did the NHS outpatient appointment answer your questions?
Please rate from 1 (poorly) to 5 (brilliantly):

 

3c. What month and year was your first NHS outpatient appointment?
Month:

Year:

 


 

4. Did you attend Complete Fertility Centre Southampton’s open evening?

please go to question 5

 

4a. How would you rate our open evening?
Please rate from 1 (poor) to 5 (brilliant):

 

4b. What month and year did you attend our open evening?
Month:

Year:

 


 

5. Has the male partner provided a semen specimen at Complete Fertility Centre Southampton?

please go to question 6

 

5a. How would you rate the specimen production room?
Please rate from 1 (poor) to 5 (brilliant):

 


 

6. Did you have fertility treatment at our centre?

please go to question 7

 

6a. Please rate the appropriateness of the information you received prior to giving consent for your treatment?
Please rate from 1 (poor) to 5 (brilliant):

 

6b. Please rate the level of dignity and sensitivity that the staff treated you with:
Please rate from 1 (poor) to 5 (brilliant):

 

6c. Please rate the level of cleanliness and hygiene at the clinic:
Please rate from 1 (poor) to 5 (brilliant):

 

6d. If applicable, please rate the drug delivery service?
Please rate from 1 (poor) to 5 (brilliant):

 

6e. Did you look at any other clinics before selecting ours?




 

6f. What month and year did you receive treatment from our centre?
Month:

Year:

 

7. How would you rate telephone enquiries to our centre?
Please rate from 1 (poor) to 5 (brilliant):

 

8. How would you rate the comfort of the waiting area at Complete Fertility Centre?
Please rate from 1 (poor) to 5 (brilliant):

 

9. How would you rate the helpfulness of your doctor at your appointments with Complete Fertility Centre?
Please rate from 1 (poor) to 5 (brilliant):

 

10. How would you rate the helpfulness of your nurse at your appointments with Complete Fertility Centre?
Please rate from 1 (poor) to 5 (brilliant):

 

11. If applicable, please rate the helpfulness of your embryologist at your appointments with Complete Fertility Centre?
Please rate from 1 (poor) to 5 (brilliant):

 

12. If applicable, please rate the helpfulness of your counsellor at your appointments with Complete Fertility Centre?
Please rate from 1 (poor) to 5 (brilliant):

 

13. Would you recommend our clinic to a friend?


 


 


By filling in this section you give consent to Complete Fertility Centre to publish the comments in the box above. (Comments will be published at the discretion of Complete Fertility Centre Southampton.)