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he questionnaire. If you would like
further copies, or would like to discuss any matters relating to this health survey, please
contact Lucy Tran on 0845 601 6030 (lo-call rate). If we have contacted you before for
similar information, please ask a family member or friend to fill it in instead. Please return
completed questionnaires to the Chinese National Healthy Living Centre before Friday 3
February 2006. A stamped, addressed envelope is enclosed for your convenience.
Please complete the questionnaire as fully as possible.
GP services
1. Are you registered with a GP?
□ Yes □ No
2. If you are not registered with a GP, please state why. Please go to question 10.
3. If you are registered with a GP, how long have you been registered?
__________years __________months
4. When was the last time you visited your GP?
□ Less than one week ago □ Between six and twelve months ago
□ One week to one month ago □ More than twelve months ago
□ Between one and two months ago □ Never visited
□ Between two and six months ago
5. For what reasons have you gone to see your GP in the past year? Please tick all that apply.
□ When you are unwell □ Regular visit for an existing
medical condition
□ To obtain test results
□ Cold/flu □ Your GP has asked you to □ To obtain medical advice
□ Feeling emotionally low □ Blood pressure check □ Other, please specify
_____________________
6. What obstacles, if any, hinder or prevent you from visiting your GP?
□ There are none □ I cannot always find an interpreter
□ I have difficulty getting to the GP surgery □ I do not get on with the GP
□ The surgery is too far away □ Other, please specify
□ I cannot communicate with the GP ___________________________
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7. Do you need an interpreter when you go to see your GP?
□ Y es, on every visit □ Yes, sometimes □ No
8. Who is your interpreter?
□ Spouse/partner □ Relative □ Interpreter provided by GP
□ Son/daughter □ Friend □ Paid interpreter
□ Other, please specify
______________________
9. To what extent do you agree with the following statements? If you need an interpreter, please
answer these questions as if your interpreter was present.
Strongly
disagree Disagree
Neither
agree
nor
disagree
Agree Strongly
agree
It is easy to make an appointment □ □ □ □ □
The time I have to wait between needing to
see my GP to actually seeing my GP is
acceptable
□ □ □ □ □
My GP is approachable □ □ □ □ □
My GP listens to my questions and
concerns
□ □ □ □ □
My GP understands my health problems
and concerns □ □ □ □ □
My GP explains my condition to me in
detail
□ □ □ □ □
I understand when my GP answers my
questions and concerns
□ □ □ □ □
I have confidence in my GP □ □ □ □ □
Dental services
10. Are you registered with a dentist?
□ Yes □ No □ Don’t know
11. If you are not registered with a dentist, please state why. Please go to question 17.
12. If yes, are you registered as an NHS patient?
□ Yes □ No
13. If you are a private patient, what do you think about the cost of seeing your dentist?
□ Reasonable □ Expensive □ Too expensive
14. When was the last time you visited your dentist?
□ Less than one week ago □ Between six and twelve months ago
□ One week to one month ago □ More than twelve months ago
□ Between one and two months ago □ Never visited
□ Between two and six mon