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Service Survey
Tell us whats good, and what can be improved about the referral management system
360 Assessment
Who are you?
*
I am a referrer
I am a commissioner
I am a patient
I am a provider
Organisation
It would be helpful if you could tell us the name of your organisation - if you don't want to - thats fine.
Name
First
Last
You can tell us your name - if you wish.
What elements of the service work well for you?
What elements of the service don’t work for you?
What developments would you like to see in the future?
What support do you need to improve your experience?
Contact
*
Yes
No
Have you ever contacted the referral management team?
The team responded to your queries quickly and efficiently?
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
The team was helpful and professional.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Have you used the website - for example to get a URN or track a referral?
Yes
No
The website was helpful, clear and provided the answers you needed.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Have you used the online referral application?
Yes
No
Please tell us why you have not used the online service?
Did you know you don't need an NHS NET email address to use the online system, you wont have to re-write rejected referrals and the system will now link to your practice software to export patient demographics?
Would you like to try using the online system?
Yes
No
Email
Please let us know your email address and we will contact you to get signed up for the online system
The online system is easy to use (either as a referrer, provider or commissioner).
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
General feedback - anything else we should know?
Email
If you would like us to reply to any comments or questions, please leave your email address.
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Yorkshire & Humber
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