Feedback Form

Feedback Form

Salus NE Ltd
Salus NE Ltd is committed to delivering safe, professional, and high-quality care and services. Your feedback is an important part of our continuous improvement process and helps us identify areas of good practice as well as opportunities to enhance our service.

This form is used to collect feedback from patients, event organisers, healthcare professionals, and members of the public. We ask that you answer the questions as openly and honestly as possible. All feedback is reviewed as part of our quality assurance and clinical governance processes.

Providing feedback will not affect the care or service you receive now or in the future. All responses are treated confidentially and managed in accordance with applicable data protection legislation.
Which of The Following Best Describes You In Relation to Salus NE (Salus Medical)?*
On What Date Did You Use or Interact With Our Service?*

DayMonthYear
Date
Where Did This Interaction Take Place?*
Event Name or Location (if not an event)
Your Name (Optional)

First NameLast Name
Your Age Range (Optional)
Are you completing this form as:*
Patient Name (Optional)

First NameLast Name
Patient Age Range (Optional)
Contact Email or Phone Number (Optional):
Your Name*

First NameLast Name
Your Role*
e.g. Organiser, Safety Officer
Organisation Name*
Contact Email or Phone Number (Optional):
Your Name*

First NameLast Name
Your Role*
e.g. Paramedic, Nurse, Doctor
Organisation Name*
e.g. North East Ambulance Service, County Durham & Darlington NHS Trust
Contact Email or Phone Number (Optional):
Your Name*

First NameLast Name
Did You Interact Directly With Salus?*
Contact Email or Phone Number (Optional):
How Satisfied Were You With The Kindness, Dignity, And Respect Shown By Salus?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Staff Introduced Themselves And Clearly Explained Their Role?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Professionalism Of Staff During Your Care?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Time Staff Gave You To Explain How You Were Feeling Or What Had Happened?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That The Assessment Carried Out Was Thorough And Appropriate For Your Condition?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Staff Explained Any Checks Or Observations They Carried Out?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Clarity Of Explanations About What Staff Were Doing And Why?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With Your Involvement In Decisions About Your Care, Where Appropriate?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Any Questions You Asked Were Answered Clearly And Honestly?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Comfort Provided During Your Care?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Reassurance Provided By Staff During Your Care?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With Your Confidence In The Care And Treatment Provided?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Your Privacy And Dignity Were Respected During Your Assessment And Treatment?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Explanation Of What Would Happen Next After Your Assessment Or Treatment?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Advice Provided About What To Do If Your Condition Changed Or Worsened?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
Would You Use Salus Again?*

YesNo
Have Your Own Say. What Did Salus Do Particularly Well? What Could We Have Done Better?
Optional
Do You Know The Names of The Staff You Interacted With From Salus?
Optional
How Satisfied Were You With The Ease Of Booking Salus For Your Event?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Clarity Of Communication Before The Event?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Responsiveness Of Salus To Queries Or Requests?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Professionalism Of Salus During The Event?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Conduct, Appearance, And Behaviour Of Staff While On Site?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With Staff Engagement With Your Event Team And Visitors?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That The Medical Cover Provided Was Appropriate For The Event Size And Type?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Timeliness Of Staff Arrival And Readiness To Deliver Services?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Organisation And Coordination Of Salus On The Day?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That The Presence Of Salus Contributed To A Safe Event Environment?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Staff’s Ability To Respond To Any Incidents Or Medical Needs Effectively?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
Would You Use Salus Again?*

YesNo
Have Your Own Say. What Did Salus Do Particularly Well? What Could We Have Done Better?
Optional
Do You Know The Names of The Staff You Interacted With From Salus?
Optional
How Satisfied Were You With The Accuracy Of Information Provided By Salus About The Patient Or Situation?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Clarity Of Communication When Interacting With Salus?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Any Questions Or Concerns Raised Were Answered Clearly And Professionally?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Appropriateness Of Care Provided By Salus Prior To Your Involvement?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That The Assessment And Interventions Were Thorough And Clinically Appropriate?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Timeliness Of Escalation Or Request For Support, Where Required?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery DissatisfiedN/A
How Satisfied Were You With The Quality Of The Patient Handover Provided By Salus?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Handover Information Was Structured, Clear, And Complete (E.G., ATMIST / SBAR)?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That All Relevant Clinical Details Were Communicated During Handover?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Professionalism And Conduct Of Salus During Your Interaction?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Ability Of Salus To Work Effectively Alongside Your Team Or Organisation?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Patient Safety Was Maintained Throughout The Interaction Or Transfer Of Care?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With Your Confidence In The Care Provided By Salus Prior To Your Involvement?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
Have Your Own Say. Please Provide Any Examples Of Good Practice Demonstrated By Salus As Well As Any Feedback Or Recommendations To Support Service Improvement:
Optional
Do You Know The Names of The Staff You Interacted With From Salus?
Optional
How Satisfied Were You With The Professionalism Of Salus, Based On What You Saw Or Experienced?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Politeness And Friendliness Of Staff, Based On What You Saw Or Experienced?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You With The Clarity Of Information About Who Salus Are And What They Do?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery DissatisfiedN/A
How Satisfied Were You With The Approach-ability And Engagement Of Salus, Based On What You Saw Or Experienced?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
How Satisfied Were You That Their Presence Made You Feel Safe Or Reassured?*

Very SatisfiedSatisfiedNeither Satisfied Nor DissatisfiedDissatisfiedVery Dissatisfied
Have Your Own Say. Please Tell Us Anything Salus Did Particularly Well or Any Suggestions For Improvement:
Optional
We Appreciate You Taking The Time To Share Your Feedback. Your Input Supports Salus NE Ltd In Delivering Safe, Professional, And High-Quality Services.
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