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 SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied

2. How helpful was the information brochure “A Guide to Neuropsychological Assessment” provided to you before the assessment? (please tick)
Very HelpfulHelpfulNeutralUnhelpfulDid 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 SatisfiedSatisfiedNeutralDissatisfiedVery Dissatisfied

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

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

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

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

8. How would you rate the neuropsychology service overall?
ExcellentSatisfactoryIn need of improvement

Additional Comments

Your Name (not required)

Your Email (not required)