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Home - Children and Young People - Health professionals - Feedback form about your health assessment

Feedback form about your health assessment

The feedback you provide is private and confidential.

Your age(Required)

11-12

13-15

16-18

Thinking about your health assessment please answer the questions below.

Did the nurse explain to you that your health assessment was confidential?(Required)

Yes

No

Was your health assessment useful?(Required)

Yes

No

Please tell us why(Required)

Were you involved in putting together your health care plan?(Required)

Yes

No

Please tell us why(Required)

Do you feel your health care plan supports you in meeting your needs?(Required)

Yes

No

Please tell us why(Required)

Were you treated with respect during your health assessment?(Required)

Yes

No

Please tell us why(Required)

Did you understand the explanations you were given during your health assessment?(Required)

Yes

No

Please tell us why(Required)

Did you understand the answers to any questions you had?(Required)

Yes

No

Please tell us why(Required)

Did you feel listened to during your health assessment?(Required)

Yes

No

Please tell us why(Required)

Were you taken seriously during your health assessment?(Required)

Yes

No

Please tell us why(Required)

Were you asked whether you wanted your health assessment to take place?(Required)

Yes

No

If no, where would you like it to be?(Required)

Do you know how to contact your nurse if you need to?(Required)

Yes

No

What has your overall experience of your health assessment been?(Required)

Excellent

Good

Satisfactory

Poor

Very Poor

Do you have any other thoughts or feelings?(Required)

Yes

No

Please share below(Required)

This feedback form is private and confidential. If you would like to discuss any of your comments with your nurse, please leave your contact details below. Your nurse will contact you for a chat.

CAPTCHA

Consent(Required)

I agree to the privacy policy.

I can confirm that I have read, understood and accept the privacy policy.

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Page last reviewed: 28/08/2024

In this section

Knowsley health professionals
St Helens health professionals
Wirral health professionals
Cheshire East health professionals
Safeguarding and Paediatric Liaison Nurse Notification Form
Feedback form about your health assessment

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