4 FFT Outpatient April 2020  
 
 
 
 
Thinking about your recent Outpatient appointment...
 Alternatively you can complete an online form at https://www.cht.nhs.uk/patients-visitors/family-and-friends-test
V1-2020
Tell us what you think about the quality of your care!
Equality Monitoring
Date of feedback:
//
What could we do better?
Site:
Which department have you been seen by?
What went well with your care and treatment?
If yes, please state:
I am answering this as a...
Relative/Carer/Advocate
(please answer the questions below
about the patient)
Patient
What is your age?
55-64
35-44
25-34
65-74
45-54
16-24
75+
Prefer not
to say
0-15
Overall, how was your experience of our service?
Good
Very
Good
Neither Good
nor Poor
Very
Poor
Don't
know
Poor
Do you have a disability?
Yes
Prefer not to say
No
What is your ethnic group?
Black
Other
Asian
White
Mixed
Prefer not to say
If you DO NOT wish your anonymous comments to be used in our promotional material, please tick here:
What is your sexual orientation?
Gay-Lesbian
Heterosexual
Prefer not to say
Bisexual
Are you male or female?
Prefer not to say
Prefer to use
my own term
Female
Male
Acre Mills
Brighouse Health Centre
Broad Street Plaza
Calderdale Royal Hospital
Castle Hill School
Huddersfield Royal Infirmary
Lister Lane Surgery
Oaklands Health Centre
Other Community Based Clinic
Other consultation method (eg. telephone, video, email, virtual clinic)
Todmorden Health Centre
Westwood Park
Audiology
Breast Clinic
Cardiology
Chemical Pathology
Clinical Genetics
Clinical Health Psychology - Bariatric Surgery
Clinical Health Psychology - Cancer
Clinical Health Psychology - Diabetes
Clinical Health Psychology - Gastro
Clinical Health Psychology - Long Covid
Clinical Health Psychology - Paediatric Diabetes
Clinical Health Psychology - Respiratory
Clinical Health Psychology - Stroke
Dermatology
Diabetic Medicine
Ear Nose and Throat (ENT)
Elderly Medicine
Endocrinology
Gastroenterology
General Medicine
General Surgery
Gynaecological Oncology
Gynaecology
Haematology
Maxillofacial Surgery
Medical Oncology
Neurology
Obstetrics
Ophthalmology (Eye Clinic)
Optometry/Optician
Orthopaedics/Trauma Clinic
Orthoptics/Orthoptist
Paediatric Cardiology
Paediatric Child Development Unit
Paediatric Diabetes Transition
Paediatric Diabetic Medicine
Paediatric Endocrinology
Paediatric Epilepsy
Paediatric Medicine
Paediatric Ophthalmology
Paediatric Surgery
Paediatric Trauma and Orthopaedics
Paediatric Urology
Pain Management
Physiotherapy
Plastic Surgery
Renal Medicine (Kidney)
Respiratory Medicine (Lung)
Rheumatology
Stroke Medicine
TIA
Urology