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Secure Surgery Website
From Wiggly-Amps Ltd
01263 834 648    info@wiggly-amps.com

Create Your Own Online Patient Forms / Questionnaires

 

You are now able to create your own secure online patient forms for your website.

 

This feature meets the requirements outlined by the Patient Participation Directed Enhanced Service (DES).

 

You can add, for example, your own New Patient Questionnaire or Travel Questionnaire! Even create your own repeat prescription form if you do not like our default one.

 

You are able to add 7 different types of questions. They are as follows:

'Well done Vic and your colleagues at Wiggly Amps, another great innovation. I was on the point of contacting you to see if you were aware for the new requirements under the Quality and Outcomes Framework for the current year surrounding the setting up of patient groups and the need to conduct a survey. It seems that you have ALREADY saved us the trouble and provided a simple method of meeting the indicator.'

Graham Brown

Dr Kumar & Partners

1. A question that requires your patients to choose 1 answer only out of those provided

2. A question that requires your patients to choose 1 or more of those answers provided

3. A question that requires your patients to type their own short answer

4. A question that requires your patients to type their own longer answer

5. A question that requires a date answer in the format dd/mm/yyyy

6. A question that requires your patients to type a valid email address

7. A question that requires your patients to type a valid telephone number

 

When you create these pages they will be https secure!

 

For each question you can choose whether you want it to be mandatory or not (i.e. the form can not be submitted unless the question is answered).

 

The results are kept in your secure logs and you are able to see what each patient submits individually. A notification of a new submission is sent to an email address or addresses of your choice.

 

We thought about adding a default New Patient Questionnaire and Travel Questionnaire to our website package but it seems you all would want to ask different questions. We thought it would be easier to let you create your own! 

 

Please click to see an example New Patient Questionnaire or Travel Questionnaire.

 

Our create your own survey feature is slightly different. Survey pages limit you to one type of question requiring patients to choose one of your available answers. The website will then add your results together and display them as a bar chart of percentages. Click here to read more.

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