General Service Feedback

Please help Dr Anderson improve his professional services by providing feedback on your experience.

1. How satisfied were you with the amount of time you had to wait for an appointment? (please tick)
 Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

2. How helpful was the information brochure “A Guide to Neuropsychological Assessment” provided to you before the assessment? (please tick)
 Very Helpful Helpful Neutral Unhelpful Did not receive it

Care Provider feedback

During your visit, how would rate your care provider (neuropsychologist) on the following?

3. Friendliness/courtesy of the care provider.
 Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

4. Concern the care provider showed for your questions or worries.
 Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

5. Degree to which the care provider talked with you using words you could understand.
 Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

6. The level of professionalism demonstrated by your care provider.
 Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

7. Your overall confidence in this care provider?.
 Very Satisfied Satisfied Neutral Dissatisfied Very Dissatisfied

8. How would you rate the neuropsychology service overall?
 Excellent Satisfactory In need of improvement

Additional Comments

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