Complete Fertility Patient Satisfaction Questionnaire

Your views are important to us and we would be grateful for your feedback. This will not affect your treatment in any way. All information goes directly to the Quality Manager.

Name (Optional)

Patient support

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

Did you feel supported by us, including the provision of emotional support:

Please can you tell us why you gave these answers?

Did anybody make a real difference to your treatment?

Administration and reception

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

	5	4	3	2	1
Communication, courtesy and friendliness of staff
Professionalism of staff
Ease of booking and availability of appointments
Comfort and atmosphere of reception
Clarity of prices and payment taking process

Is there anything else you would like to share about this area of our service?

Medical consultations

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

	5	4	3	2	1
Assessment of your individual case and explanation of your treatment options
Meeting with the consultant/doctor and the time given during the visit
Professionalism of doctors

Were your appointments on time?

If not on time, by how long?

Is there anything else you would like to share about this area of our service?

Nurse appointment

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

	5	4	3	2	1
Clarity of explanation of proposed treatment with the opportunity for discussion
Scanning
Injection training
Professionalism of nurses

Were your appointments on time?

If not on time, by how long?

Is there anything else you would like to share about this area of our service?

Laboratory team

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

	5	4	3	2	1
Clarity of explanation of embryology update with opportunity for discussion
Facilities for producing semen sample (if applicable)
Obtaining results and clarity of the results
Professionalism of laboratory staff

Were your appointments on time?

If not on time, by how long?

Is there anything else you would like to share about this area of our service?

Donor team

Did you receive support from the donor team

during your treatment?

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

Is there anything else you would like to share about this area of our service?

Counselling

Did you receive support from our Counselling service

during your treatment?

Were you given the option of face to face, Zoom

or telephone counselling?

YesNo

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

	5	4	3	2	1
Was the wait time for this appointment acceptable?
Did you feel your counselling session(s) was comfortable and confidential?
Was your counselling session(s) helpful?

Is there anything else you would like to share about this area of our service?

Treatment in general

Please select the appropriate number to indicate the standard of service.

5 Excellent 4 Good 3 Average 2 Poor/requires improvement 1 Very poor/requires significant improvement

For DORSET NHS patients only. Were you provided with a choice of 3 providers for your treatment (Complete, Southampton; Salisbury Hospital; Bath Fertility):

YesNo

Any other comments or suggestions for us to improve our service in the future?

Would you like to be contacted for any follow up regarding your feedback

Do you consent for Complete Fertility Centre to use your anonymised comments on their website?

	5	4	3	2	1
Quality of information provided about treatments and procedures
Clarity of prices
Communication with the clinic
Empathy and sensitivity to your situation

	5	4	3	2	1
How well supported did you feel throughout your patient journey
Did you you feel we showed empathy and sensitivity to your situation?

	5	4	3	2	1
Clarity of explanation of proposed treatment with the opportunity for discussion
Professionalism of donor team