Questionaire for clients of Midwifery practice Santé.

logo Midwifery practice Santé
We value your opinion about the care we have given to you, to evaluate and continually improve our work methods.

We would like to ask you to fill in this questionaire. It will cost you approximately 10-15 minutes of your time.
Thanks in advance  for your cooperation.



Start of the questionaire.
Please start at the beginning. Your answer will determine which questions are applicable in your situation:

Did we care for you in the case of a miscarriage yes no

 

 

CHOICE OF PRACTICE
1.The website of the practice appealed to me.Completely
disagree
      Completely
agree
n/a
2.My surroundings recommended this practice.Completely
disagree
      Completely
agree
n/a
3.My general practitioner or hospital recommended this practice.Completely
disagree
      Completely
agree
n/a
4.The practice is easily accessible by car/bicycle/public transport.Completely
disagree
      Completely
agree
n/a
5.The fact that ultra sounds are made in this practice, was an important factor in choosing this practice.Completely
disagree
      Completely
agree
n/a
6.Evening opening hours were important to me.Completely
disagree
      Completely
agree
n/a
7.I chose this practice because I had a positive experience last time.Completely
disagree
      Completely
agree
n/a
8 Different reason, namely….

Which subject mentioned above ranks as most mportant to you:



Explanation about choice of practice:




ABOUT THE PRACTICE
41.The practice is easily reachable by phone and/or email.Completely
disagree
      Completely
agree
n/a
42.I was treated by the practice assisment in a pleasant manner.Completely
disagree
      Completely
agree
n/a
43.I was treated by the midwives in a pleasant manner.Completely
disagree
      Completely
agree
n/a
44.I am content with the waiting time.Completely
disagree
      Completely
agree
n/a
45.I am content about the waiting room.Completely
disagree
      Completely
agree
n/a
46.I am content about the consultation room.Completely
disagree
      Completely
agree
n/a
47.I am content with the amenities ( ie toilets, nappy changing station, drinks, toys, reading material).Completely
disagree
      Completely
agree
n/a
48.My privacy was sufficiently taken into account.Completely
disagree
      Completely
agree
n/a
49.My personal file was treated with care.Completely
disagree
      Completely
agree
n/a
50.The attendance of a student midwife was fine by me.Completely
disagree
      Completely
agree
n/a

Which subject mentioned above ranks as most mportant to you:



Explanation about about the practice:




OTHER QUESTIONS
51.I would prefer that the midwife prescribes my contraceptives, rather than a GP or an obstetrician/gynaecologist.Completely
disagree
      Completely
agree
n/a
52.I'm happy with the possibility of the 6 week postpartum check-up with the midwife.Completely
disagree
      Completely
agree
n/a

Explanation about other questions:






DO YOU HAVE ANY FURTHER TIPS OR REMARKS?

Tips/remarks:
What grade would you give this practice ( please click the number of your choice 1-10)

1

2

3

4

5

6

7

8

9

10

PRIVACY STATEMENT

Your midwifery practice is the only one using the information you've given. This is to measure customer satisfaction. Possibly your answers will give us reason to contact you. We also simply enjoy reading your comments and see who wrote what. For that reason you can choose to write your name under the questionnaire.


Yes, I have read the privacy statement (link opens in a new window) and undersign this questionnaire.
I would like to participate anonymously.
My name: