Patient Experience Survey

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Patient Experience Survey

Which ward were you discharged from?

In which Month and Year were you discharged from hospital?

Month:
Year:

Q1. Were you involved as much as you wanted to be , in decisions about your care and treatment?

Yes, definitely
Yes, to some extent
No

Q2. Were you given enough privacy when discussing your condition or treatment?

Yes, always
Yes, sometimes
No

Q3. Did you find someone on the hospital staff to talk to about your worries and fears?

Yes, definitely
Yes, to some extent
No
I had no worries or fears

Q4. Did a member of staff tell you about medication side effects to watch for when you went home?

Yes, completely
Yes, to some extent
No
I did not need an explanation

Q5. Did hospital staff tell you who to contact if you were worried about your condition or treatment after you left hospital?

Yes
No
Don't Know / Can't Remember

Additional comments

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