Appendix 6 - Patient Satisfaction Questionnaire
Paediatric Audiology Service Satisfaction Questionnaire
Please complete the questionnaire below to help us improve Audiology services. Indicate your level of satisfaction for each item with a tick. Please base your responses on all of the appointments you have received over the last few months, and on your and your child's experience.
Overall, how satisfied are you with:
| Very
satisfied | Satisfied
Somewhat | Dissatisfied | Very
dissatisfied |
|---|
Accessibility |
|---|
Your experience communicating with the Audiology Service? | | | | |
The time you waited for your child's appointments? | | | | |
The time you waited at your appointments? | | | | |
The location of your appointments?
(How accessible from your home) | | | | |
The hearing aid repair and battery replacement service? | | | | |
Surroundings |
|---|
The signage directing you to the Audiology department? | | | | |
Your welcome at reception? | | | | |
The child-friendliness of the waiting room? | | | | |
The child-friendliness of the clinic rooms? | | | | |
The comfort of the clinic rooms? | | | | |
Information |
|---|
The information you received with the appointment letters? | | | | |
The written information you received at the appointments? | | | | |
The information in the waiting room? | | | | |
Staff |
|---|
The professionalism of the reception staff? | | | | |
The professionalism of the audiologist? | | | | |
Care & Treatment |
|---|
The opportunities to discuss any problems or difficulties? | | | | |
Any explanations you were given? | | | | |
The assessment and management of your child's hearing needs? | | | | |
The appropriate involvement of other services? | | | | |
Overall |
|---|
The audiology service you received? | | | | |
Please state below one improvement you would make to the Audiology Service or please add any comments? |
|
Section below for completion by Audiology staff:
Clinic ________________________________________________
Date ______________
Type of Appointment
_________________________________________________________
Comments