Minor Procedure Feedback Form

0114 230 7818

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You have been directed to this page because you have recently had a minor procedure by one of our GPs. We value patient feedback and would greatly appreciate it if you could complete a few short questions below.

We do not need your personal details and this information is only used to provide feedback to our doctors.

What was the date of your procedure?

Which GP completed your minor procedure?*

Were the surgery facilities satisfactory

No Yes

Before the procedure

Did you understand how the operation would be done?

No Yes

Did you understand why we were doing the operation?

No Yes

Were you told about possible complications of the operation?

No Yes

After the procedure

How much information about your condition or treatment was given to you?

The right amount Not enough (what would you have liked to know?) Too much

Were you given a leaflet about caring for your wound?

No Yes

Did you understand how to look after your wound?

No Yes

Following the operation was your wound...

Mildly painful? Not painful at all? Moderately painful? Very painful?

Did you have an infection after your operation requiring antibiotics?

Yes No

Did your wound open up after the stitches were removed?

N/A Yes a lot No Yes a little

Did your wound bleed for prolonged periods after your operation when you were at home? i.e. did you need to press on the wound for more than 10 minutes or attend the hospital or surgery because of it?

Yes a little Yes a lot No

Where you happy with the result of your surgery?

No Yes

How would you rate your experience of using this service overall?

4 2 1 (Very dissatisfied) 3 5 (Excellent)

We are always looking to improve our service: Please feel free to make any comments or suggestions in the space below:

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