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What is anaesthesia
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Gastrointestinal (GI) Endoscopy
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Pre-op questionnaire
Post-op Questionnaire
Paediatric anaesthesia
FAQs
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send a message
Home
About
For Patients
Information
What is anaesthesia
Side effects
Your role in your preparation
Fasting
Medications and anaesthesia
Specific procedures
Going Home
Fees
Surgeons
Hospitals
Types
Dental Surgery
Ear Surgery
Gastrointestinal (GI) Endoscopy
Gynaecological Surgery
Hand Surgery
Knee Surgery
Nose Surgery
Tonsillectomy and Adenoidectomy Surgery
Questionnaires
Pre-op questionnaire
Post-op Questionnaire
Paediatric anaesthesia
FAQs
Contact
Post-op Questionnaire
As specialist medical doctors, we are always looking to improve our practice. Requesting feedback is a mandatory activity for our continuing professional development. We thank you for taking the time to fill in this quick questionnaire regarding your recent hospital stay
Please choose your Anaesthetist
Jane Hosking
Your name
Email
Completing this for:
Yourself
Your child
Other
Other
Date of operation
MM slash DD slash YYYY
Hospital
Were you happy with the information provided prior to your anaesthetic?
Yes
No
Thinking only on the first 48 hours after your operation, please indicate if you had any of the following
Pain
None
Mild
Moderate
Severe
Nausea, dry retching, vomiting
None
Mild
Moderate
Severe
Difficulty breathing
Not at all
Some of the time
Most of the time
All of the time
Difficulty passing urine
Not at all
Some of the time
Most of the time
All of the time
Difficulty sleeping at night
Not at all
Some of the time
Most of the time
All of the time
Difficulty looking after yourself
Not at all
Some of the time
Most of the time
All of the time
A feeling of general well being
Not at all
Some of the time
Most of the time
All of the time
Being able to understand instructions and not being confused
Not at all
Some of the time
Most of the time
All of the time
Feeling of support from hospital staff
Not at all
Some of the time
Most of the time
All of the time
Anything else you would like to feedback to your Anaesthetist?
Thank you for your time. Hitting 'submit' will send your response to your Anaesthetist.
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