GMC Questionnaire - Alastair Fry

1: Are you filling in this questionnaire for:

Yourself

Your child

Your spouse or partner

Another relative or friend

If you are filling this in for someone else, please answer the rest of this questionnaire from the point of view of the patient.

2: Which of the following best describes the reason you saw Mr Fry?

To ask for advice

Because of a one-off problem

Because of an on-going problem

For a routine check

For treatment

Other (please give details)

3: How important to your health and wellbeing was your reason for seeing Mr Fry?

Not at all important

Only slightly important

Important

Very important

Extremely important

4a: How good was Mr Fry at being polite?

4b: How good was Mr Fry at making you feel at ease?

4c: How good was Mr Fry at listening to you?

4d: How good was Mr Fry at assessing your medical condition?

4e: How good was Mr Fry at explaining your condition and treatment?

4f: How good was Mr Fry at involving you in decisions about your treatment?

4g: How good was Mr Fry at providing or arranging treatment for you?

5a: Do you agree or disagree that Mr Fry will keep information about you confidential?

5b: Do you agree or disagree that Mr Fry is honest and trustworthy?

6: Are you confident about Mr Fry's ability to provide care?

Yes

No

7: Would you be happy to see Mr Fry again?

Yes

No

8: Was this a visit with your usual doctor?

Yes

No

9: Please add any other comments you wish to make about Mr Fry to the General Medical Council here.

PLEASE NOTE: This GMC questionnaire has NO identifying information by design. No patients will be identified when this information is given to Mr Fry.

10: What gender are you (or the patient, if you are completing this on behalf of a child or other person)?

Male

Female

I'd prefer not to say

11: What age are you (or the patient, if you are completing this on behalf of a child or other person)?

12: What is your ethnic group? 12: What is your ethnic group?

Thank you for your feedback!