Northdown Surgery Patient Participation Group Survey

Anima Online Request Form

This questionnaire/survey is the second of two developed by our PPG to monitor how primary care services at this surgery are delivered and how patients experience them. It is also to evaluate various aspects of patient experience including access to care, appointment scheduling and general quality of care received from healthcare professionals and whether they are ‘fit for purpose’.

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* 1. Do you use a computer/mobile phone?

Yes

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* 2. Which web browser are you using to access the Anima form?

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* 3. If you do not have access to a computer, would you be happy to use one in surgery?

Yes

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* 4. Is the anima form doing what you need it to do?

Yes

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* 5. If you answered 'No' to the previous question, please select from the following:

My query wasn’t answered/resolved

Unable to reply, should be a unique number for response or request follow up

Form/wording too complicated

Process took too long

Should be able to complete form on 24-hour cycle

The size of print is too small

My language is not on the drop-down list

Confusion over which box to select for sicknotes

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* 6. Were you satisfied with the health professional you were allocated?

Yes

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* 7. Were you happy with the advice/treatment?

Yes

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* 8. Did the healthcare professional provide a follow up appointment if applicable?

Yes

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* 9. Was your appointment within a reasonable time?

Yes