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Telehealth Patient Appointment Evaluation Form
Please tell us about your telehealth appointment. Your feedback helps us improve our services!
1.
What is your postcode?
2.
Which town or postcode were you in to attend your telehealth appointment today?
3.
Which town was the specialist/health professional in?
4.
The telehealth consult was held at:
Local Health Service
Home
GP Practice
Other (please specify)
5.
I would normally travel to my appointment by:
Driving myself
Friend or family member drives me
Public transport
I wouldn't attend
Other (please specify)
6.
I felt I received the same standard of care as I would have from a face to face appointment:
Strongly agree
Agree
Unsure
Disagree
Strongly disagree
7.
will use telehealth again:
Yes
No - if No, can you tell us why?
8.
Did you have someone assist you during your appointment:
No
Yes - if Yes, who assisted you?
9.
Joining the video call was easy for me:
Yes
No - if No, can you tell us why?
10.
Any other comments?
Thank you very much for your answers, we appreciate the time you have taken to help us improve our services!