Patient Evaluation Form

Patient evaluation form

Here at Spirit Health, we aim to support the NHS in continuing to deliver quality patient care. Your feedback matters. By taking a few minutes to complete this form we’ll use your valuable feedback to understand how we can improve our services when interacting with future patients.

Please complete the following fields:

"*" indicates required fields

Please select how much you agree with the following statements (if applicable)
I am happy with the changes made today to my treatment*
I understood the information the Spirit staff gave me regarding my new treatment*
The Spirit staff were polite and professional*
I felt able to ask questions about my care and I have all the information I need about the changes recommended today*
Are you happy for us to contact you in the future to see how you’re getting on?*
Name

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