Patient Communications Questionnaire

We wish to understand and record any particular communication needs you might have.

We will then do our best to meet your needs in all contacts with the surgery.

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Personal Details

Completed By: *

Accessibility Information

Is your communication with others affected by a health problem or disability which has lasted, or is expected to last, at least 12 months?: *

Can we share this information with other health and social care providers?:

If NO you do not need to answer any other questions

Privacy Consent

This form collects personal and medical informanot tion 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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CONTACT DETAILS

Budleigh Salterton Medical Centre
1 The Lawn
Budleigh Salterton, EX9 6LS

Enquiries: 01395 441 212
Out of Hours:111

Please note that all calls are recorded. A telephone call will only be retrieved and heard, should there be a clinical reason to do so for training purposes, or a complaint that requires investigation.

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Patient Communications Questionnaire

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