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* 1. Date of attendance

Date

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* 2. Who have you seen today?

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* 3. How would you rate the quality of the service you received at your appointment?

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* 4. What was the main reason for attending today?

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* 5. What did you think of how long you had to wait for your appointment after booking it?

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* 6. How did you find out about the Sexual Health service?

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* 7. How likely are you to recommend the GP Access Service to friends and family if they needed the similar care or treatment?

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* 8. Please state which ethnic group you consider yourself to be?

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* 9. If you have any suggestions, or there is anything you would like us to know about your experience of attending the Sexual Health Service today- good or bad- please tell us here:

T