Feedback Form for Minor Procedures

  • Personal Information
  • The Procedure
  • After the Procedure
Your personal information
During and Before the procedure
Did you understand how the procedure would be done?
Did you understand why we were doing the procedure?
Were you told about possible complications of the procedure?
How much information about your condition or treatment was given to you?
The results of the procedure
Were you given a leaflet about your procedure or the after effects?
Were you happy with the result of your procedure?
On a scale of 1-5 how much has your pain improved (1 being not at all 5 being completely)
On a scale of 1-5 how would you rate your experience of using this service overall
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