Epsomedical operates theatres on sites without ITU (intensive care) facilities.  Patients listed for a procedure at our units are asked to complete an online medical questionnaire designed to help us confirm as quickly as possible that they can be safely treated in our theatres.


Please click on the link below to complete questionnaire.  You will need to enter your patient number and date of birth.  Your patient number can be found on any correspondence sent by us underneath your name and address.  Whilst developed for most devices, the questionnaire works best on a desktop web browser i.e. Internet Explorer or Google Chrome.  To prevent multiple clicking back to your year of birth, Android uses should tap the year presented on the calendar and then scroll back.

Should you make an error during the completion of the document, you will get a chance to change the entry using the edit link on the last page before submission.  Your information is held securely on our encrypted server and cannot be accessed once submitted.

Should you encounter any problems with the questionnaire, please send us an emial via the General Contact tab on this page.

Online Medical Questionnaire

PATIENT SATISFACTION SURVEY

Epsomedical welcomes your feedback on the services we provide.  To complete our survey, please click on the icon below.  Alternativley, you can visit the NHS Choices website where customer ratings are collected and published for all NHS providers.  We will ask for your patient number to validate the feedback, but this will not compromise your anonymity should you not wish your identity to be known.  Your patient number is on all correspondence under your name and address. 

Please click on the link below to start the survey.  Should you experience any difficulty, please contact us via the General Contact tab on this page.

Patient Satisfaction Survey

POST OP PAIN SURVEY

We need to know whether patients discharged after surgery experience any post operative complications or suffer unexpected levels of pain.  All patients who have undergone a procedure under general anaesthetic are asked to complete this survey the day after surgery, whether or not they have these sypmtoms.  Any patient experiencing severe symptoms should call the hospital.

Please click on the link below to start the survey.  If you experience any difficulty, please send an email via the General Contact tab on this page and we will call you.

Post OP Pain Survey