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Eastern Community Health Team
Address: Patient Access via Botany Super Clinic
260 Botany Road,
Botany,
Auckland 2013
Eastern Community09Health
Telephone: Team
270 4758 (Answer phone after hours)
Address: In an emergency
Patient Access via callBotany
an Ambulance – Phone 111
Super Clinic
Hours: 260 Botany
Monday Road,8.00am – 4.30pm
– Friday;
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Botany, Sunday; nursing only 8.00am – 4.30pm
Address:
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09Physiotherapists;
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Discharge Information
On discharge from our service, your G.P or referrer will be sent a summary of the
care you have received from the service and you may also receive a copy of this.
Should you have any further problems contact your G.P to discuss care options.

…..

Patient Survey Questions Eastern Commuity Health Team
Date:
Age: Ethnicity: Gender:

Thank you for taking the time to complete these questions. Your comments are
important to us and we welcome feedback that supports service improvement.
Patient Survey Questions Eastern Commuity Health Team
Date:
Q1. How satisfied are you that your therapist /nurse/paid carer listened to your
Age: while providing assessment
needs Ethnicity:
and or care? Gender:

Thank you for taking the time to complete these questions. Your comments are
Very satisfied
important Satisfied
to us and we Dissatisfied
welcome feedback that supportsVery dissatisfied
service improvement.N/A
Patient Survey Questions Eastern Commuity Health Team
Date:
Q2.
Q1. How
How satisfied
satisfied are
are you
you that
that any
yournew/modified equipment
therapist /nurse/paid received
carer during
listened this
to your
service
Age: will meet your needs?
Ethnicity:
needs while providing assessment and or care? Gender:

Thank you for taking the

Very satisfied
satisfied time to complete
Satisfied these questions.
Dissatisfied Your
Very comments areN/A
dissatisfied
Patient
importantSurvey
Very Questions
to us and
Satisfied
we welcome Eastern Commuity
Dissatisfied
feedback Health
that supports
Very Team
dissatisfied
service improvement.
N/A
Date:
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Q2.
Age:How satisfied are you that any new/modified equipment
Ethnicity: Gender: received during this
Q1. How satisfied
informed areprocess?
during the you that your therapist /nurse/paid carer listened to your
service will meet your needs?
needs while providing assessment and or care?
Thank you for taking the time to complete these questions. Your comments are
Very satisfied Satisfied Dissatisfied Very dissatisfied N/A
Very satisfied
important to us and weSatisfied
welcome feedbackDissatisfied
that supports Very dissatisfied
service improvement.N/A
Very satisfied Satisfied Dissatisfied Very dissatisfied N/A
Q4.How
Q3. Were
Q1. satisfied were
you satisified
How satisfied you
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that timeliness
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carer kept
/nurse/paid carer listened you
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Q2. How satisfied are you that any new/modified equipment received during this
informed
needs during
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service will meet your needs?
Very satisfied Satisfied Dissatisfied Very dissatisfied N/A
Very satisfied Satisfied
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other comments? Satisfied Dissatisfied Very dissatisfied N/A
Q2. Howsatisfied
Q4.How
Q3. Were satisfied are you
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Very satisfied Satisfied Dissatisfied Very dissatisfied N/A
Very satisfied
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Any other comments?
Q3. Were
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negative impact theyour
process?
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Very satisfied Satisfied Dissatisfied Very dissatisfied N/A

Very satisfied Satisfied Dissatisfied Very dissatisfied N/A
Tear this off and give it to a staff member or if in clinic place into the box
Any other thank
provided, comments?
Q4.How satisfiedyou.
were you with the timeliness of the service provided to you?
Thank you for your feedback please be reassured providing this will have no
negative impact on your care.
 countiesmanukau.health.nz

Form code: CHS004 Review Date: December 2023