eConsult Questionnaire

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Please share your experiences by completing the form below. You can do this anonymously. We are unlikely to respond to patients but if we would like to find out more about your experience, with your permission, we will contact you.

Personal Details

Please double check you've entered the correct email address

Please specify the ethnic group you consider you belong to: : *

Questions

How many times have you used Engage Consult in the last 3 months?: *

How satisfied are you with your experience(s) of Engage Consult?: *

1 being the worse - 10 being the best

Considering the most recent time you used Engage Consult

Did you complete the multi-step questionnaire?: *

At the end of the journey had your expectations been met?: *

Did you know you can complete an Engage Consult on behalf of someone you care for?: *

Do you feel confident in using a computer or mobile device to make a request using Engage Consult?: *

Privacy Consent

This form collects personal and medical information about you. We use this information to allow the practice team to contact you. Please read our Privacy Policy to discover how we protect and manage your submitted data.

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eConsult Questionnaire

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