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Submitted URL: https://rb.gy/qm4hv4
Effective URL: https://www.oc-meridian.com/OCQ/completion/custom/PlymouthNHS/288.aspx?slid=33&did=&LanguageID=0&tkn=V62L_03ZM5SuL5nRYuuEamt...
Submission: On May 08 via manual from SE — Scanned from GB
Effective URL: https://www.oc-meridian.com/OCQ/completion/custom/PlymouthNHS/288.aspx?slid=33&did=&LanguageID=0&tkn=V62L_03ZM5SuL5nRYuuEamt...
Submission: On May 08 via manual from SE — Scanned from GB
Form analysis 1 forms found in the DOM
Name: form1 — POST ./288.aspx?slid=33&did=&LanguageID=0&tkn=V62L_03ZM5SuL5nRYuuEamt_EPjZrUoA-wI9-ZM72VzwjXzAgLRyYouzkhnsJnK65sM7WyRxrEbEq8hWJTfurvw6qb6YSFiU0DOxqV-FLZFw_AkoXoNxQYr9M9JRGgbS
<form name="form1" method="post" action="./288.aspx?slid=33&did=&LanguageID=0&tkn=V62L_03ZM5SuL5nRYuuEamt_EPjZrUoA-wI9-ZM72VzwjXzAgLRyYouzkhnsJnK65sM7WyRxrEbEq8hWJTfurvw6qb6YSFiU0DOxqV-FLZFw_AkoXoNxQYr9M9JRGgbS" id="form1">
<div>
<input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="/wEPDwUENTM4MWRkQb9HXG/WyfUwzjFgVbQ94Jb4xx0=">
</div>
<script type="text/javascript">
//<![CDATA[
var OCQ = {
ScrollPosition: 0
};
$(document).ready(function() {
if (parent) {
if ($.isFunction(parent.resize)) {
parent.resize(false, OCQ.ScrollPosition);
}
}
$(document).ajaxStop(function() {
if (parent) {
if ($.isFunction(parent.resize)) {
parent.resize(false, OCQ.ScrollPosition);
}
}
});
});
function ajaxCall_ValidateAuthToken_completionUpdate() {
closeMask();
cacheSetup();
return;
var dataPassed = "";
$.ajax({
type: "POST",
contentType: "application/json; charset=utf-8",
dataType: "json",
data: "{params:'" + dataPassed + "', sprocName: '' , sessionid: '" + "".replace(/\//g, 'DATESLASHFORWARD') + "' , con: '" + "PlymouthNHS".replace(/\//g, 'DATESLASHFORWARD') + "' , token: '" + $('#token').val().replace(/\//g,
'DATESLASHFORWARD').replace(/'/g, "APOSTROPHIE").replace(/#/g, "HASHREPLACE") + "' , slid: '" + "33".replace(/\//g, 'DATESLASHFORWARD') + "' , app: '" + "PlymouthNHS".replace(/\//g, 'DATESLASHFORWARD') + "' }",
url: "/OCQ/services/CompletionpageService.asmx" + "/ValidateAuthToken",
success: function(msg) {
var result = msg.d;;
},
error: function(XMLHttpRequest, textStatus, errorThrown) {
if (XMLHttpRequest.readyState < 4) {
XMLHttpRequest.abort();
} else {
;
}
}
});
}
//]]>
</script>
<div>
<input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="9C7CABEF">
</div>
<div id="CompletionLoading">
</div>
<div id="completionContainer" class="container">
<div id="runningCalculation">
<div class="documentUpload" onclick="radio('fileUpload').broadcast();"><span class="documentText">Upload</span> 📷 <span id="documentCount"></span></div>
<div class="runningCalculationControl" onclick="TopOfWindow()">â–²</div>
<div class="runningCalculationControl" onclick="CurrentQuestion()">â–¬</div>
<div id="runningCalculationResult"></div>
</div>
<!-- maybe we shouldput this in the code behind -->
<div id="BMIMaster">
<div id="BMICalculation"> How are you recording these figures? <div>
<input type="radio" name="calc" class="bmiselection" id="Metric" datapopup="bmi_metric"><label id="metricLbl" for="Metric" class="bmiLabel">Metric (CMs/KGs)</label>
<input type="radio" name="calc" class="bmiselection" id="Imperial" datapopup="bmi_imperial"><label id="imperialLbl" for="Imperial" class="bmiLabel">Imperial (Feet/Inches & St/Lbs)</label>
</div>
<div id="bmi_metric" class="BMICalc Metric Hidden">
<div>Height (CMs):<input type="text" id="metric_height" class="bmiinput" maxlength="4" pattern="[0-9]*"></div>
<div>Weight (KGs):<input type="text" id="metric_weight" class="bmiinput" maxlength="5" pattern="[0-9]*"></div>
<div>Loss in last 6 months (KGs):<input type="text" id="metric_weightloss" class="bmiinput" maxlength="5" pattern="[0-9]*"></div>
</div>
<div id="bmi_imperial" class="BMICalc Imperial Hidden">
<div>Height (Feet/Inches):<input type="text" id="imperial_height_2" maxlength="2" pattern="[0-9]*" class="bmiinput"> <input type="text" pattern="[0-9]*" id="imperial_height_1" class="bmiinput" maxlength="2">
</div>
<div>Weight (St/Lbs):<input type="text" id="imperial_weight_2" pattern="[0-9]*" class="bmiinput" maxlength="2"> <input type="text" pattern="[0-9]*" id="imperial_weight_1" class="bmiinput" maxlength="2"></div>
<div>Loss last 6 months(St/Lbs):<input type="text" id="imperial_weight_4" pattern="[0-9]*" class="bmiinput" maxlength="2"> <input type="text" pattern="[0-9]*" id="imperial_weight_3" class="bmiinput" maxlength="2"></div>
</div>
<div id="BMIOutput"><span id="BMIResultLabel">Your BMI = </span><span id="BMIResult"></span>
<!--used for storing and lookup data-->
<div id="BMIComment" class="Hidden"></div>
<div id="BMIWeight" class="Hidden"></div>
<div id="BMIHeight" class="Hidden"></div>
<div id="BMIWeightLoss" class="Hidden"></div>
</div>
</div>
</div>
<input type="hidden" name="ctl00$parentquestionnaire" id="parentquestionnaire" value="722">
<div class="TopOfQuestionnaires">
</div>
<div class="Questionnaires">
<div id="Questionnaire722" class="Questionnaire" questions="8" questionnaireid="722" parentid="722" calc="1" questionnairename="FFT - Outpatient" disablesequential="False">
<div id="welcomeText722" class="QuestionnaireWelcomeText">
</div>
<div id="closingText722" class="QuestionnaireClosingText">
</div>
<div class="TopOfQuestionnaire">
<span id="TopQuestionnaireText" class="TopQuestionnaireText" onclick="radio('TopQuestionnaireTextClick').broadcast()"> </span>
<div class="HomeIcon" onclick="radio('HomeIconClicked').broadcast()">
</div>
</div>
<div class="TopOfQuestionnaireIntro">
<span id="PageTitle"> </span>
</div>
<div class="BodyOfQuestionnaire">
<script>
function validateHeaderSelections722() {
return ((true == (getItemById('Branch').selectedIndex != 0)) && (true == true))
}
</script>
<div id="sectionheader722h" class="Section HeaderContainer">
<div id="header1384" class="Header" scorecardid="722" headerid="1384" headertype="3">
<span class="HeaderText">Date of your Outpatient appointment:</span>
<div>
<table border="0" style="border:none !important;">
<tbody>
<tr>
<td><select name="ctl00$drpDay" id="drpDay" class="inputTextBoxSCCompletion standardDate" onchange="setDaysSpecific('drpDay', 'drpMonth', 'drpYear', 'ctl00_' );radio('DateHeaderValueSelected').broadcast();">
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option selected="selected" value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select></td>
<td><select name="ctl00$drpMonth" id="drpMonth" class="inputTextBoxSCCompletion standardDate" onchange="setDaysSpecific('drpDay', 'drpMonth', 'drpYear', 'ctl00_' );radio('DateHeaderValueSelected').broadcast();">
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option selected="selected" value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
</select></td>
<td><select name="ctl00$drpYear" id="drpYear" class="inputTextBoxSCCompletion standardDate" onchange="setDaysSpecific('drpDay', 'drpMonth', 'drpYear', 'ctl00_' );radio('DateHeaderValueSelected').broadcast();">
<option value="2023">2023</option>
<option selected="selected" value="2024">2024</option>
</select></td>
<td></td>
</tr>
</tbody>
</table>
</div>
</div>
<div id="header1382" class="Header" scorecardid="722" headerid="1382" headertype="1" controlid="Branch">
<span class="HeaderText">Which Outpatient Department did you attend?</span>
<div class="Hidden">
<select name="ctl00$Branch" id="Branch" class="inputTextBoxSCCompletion" textparentid="HeaderText1382" onchange="headerDependency(this);">
<option selected="selected" value="Please Select...">Please Select...</option>
<option value="Audiology">Audiology</option>
<option value="Cardiology Dept">Cardiology Dept</option>
<option value="CCaSSH - Cumberland Centre">CCaSSH - Cumberland Centre</option>
<option value="CCaSSH - Kingsbridge Hospital">CCaSSH - Kingsbridge Hospital</option>
<option value="CCaSSH - Tavistock Clinic">CCaSSH - Tavistock Clinic</option>
<option value="CCaSSH - The Zone">CCaSSH - The Zone</option>
<option value="CDC CT">CDC CT</option>
<option value="Chemo Outpatients">Chemo Outpatients</option>
<option value="Chest Clinic">Chest Clinic</option>
<option value="Chestnut Unit">Chestnut Unit</option>
<option value="Children and Young People OPD">Children and Young People OPD</option>
<option value="Chronic Pain Services">Chronic Pain Services</option>
<option value="Dental Specialities">Dental Specialities</option>
<option value="Dermatology OPD">Dermatology OPD</option>
<option value="Derriford Hub">Derriford Hub</option>
<option value="Diabetes Centre">Diabetes Centre</option>
<option value="Dietetics">Dietetics</option>
<option value="DVT Clinic">DVT Clinic</option>
<option value="Eden">Eden</option>
<option value="Endoscopy Unit">Endoscopy Unit</option>
<option value="ENT OPD">ENT OPD</option>
<option value="Gynae OPD">Gynae OPD</option>
<option value="Healthy Bones">Healthy Bones</option>
<option value="Home Park Hub">Home Park Hub</option>
<option value="Hydrotherapy">Hydrotherapy</option>
<option value="Lancaster Suite">Lancaster Suite</option>
<option value="Lynher">Lynher</option>
<option value="Main OPD">Main OPD</option>
<option value="Main OPD-Upper GI OG">Main OPD-Upper GI OG</option>
<option value="Neurophysiology">Neurophysiology</option>
<option value="Nuclear Medicine">Nuclear Medicine</option>
<option value="Ocean Suite">Ocean Suite</option>
<option value="Oncology OPD">Oncology OPD</option>
<option value="Orthopaedic OPD">Orthopaedic OPD</option>
<option value="OT OPD">OT OPD</option>
<option value="Phlebotomy Community">Phlebotomy Community</option>
<option value="Phlebotomy Hospital">Phlebotomy Hospital</option>
<option value="Physio OPD">Physio OPD</option>
<option value="PIU">PIU</option>
<option value="Plastic Surgery Trauma Unit">Plastic Surgery Trauma Unit</option>
<option value="Plymouth Dialysis Unit">Plymouth Dialysis Unit</option>
<option value="Pre-assessment">Pre-assessment</option>
<option value="Primrose">Primrose</option>
<option value="Radiotherapy OPD">Radiotherapy OPD</option>
<option value="REI OPD">REI OPD</option>
<option value="Renal OPD">Renal OPD</option>
<option value="SALT">SALT</option>
<option value="Womens Day Services">Womens Day Services</option>
<option value="YourSHIP Clinic">YourSHIP Clinic</option>
</select>
</div>
<div class="HeaderLabel" controlid="Branch" onclick="radio('SelectHeader').broadcast('Branch', 1382, this)">
<span id="Branch_val" class="hfDropLabel">Please Select...</span>
</div>
</div>
<div class="NextAndPreviousButtonsHolder Header ">
<span class="HeaderText"></span>
<div id="NextQuestion" class="ActionButton Next" onclick="MoveToNextQuestion(0, 0, 722, true)">Next </div>
</div>
</div>
<div id="section2471" class="Section" questioncount="4">
<div id="SectionText2471" class="SectionText" role="heading" tabindex="-1"> Thinking about your recent visit...<span id="SectionCollapse2471" class="SectionCollapseExpand" sectionid="2471" aria-hidden="true">â–²</span>
</div>
<div id="SectionQuestion2471" class="SectionQuestions">
<div id="Question15103" class="Question" qnum="1" responserequired="True" scorecardid="722" questionid="15103" sectionid="2471" responsetype="1" qstype="1" groupid="3917" maxvalue="12" questiontype="1">
<div class="QuestionTextHolder SingleSelect">
<span id="QuestionTextNo15103" class="QuestionTextNo" questionid="15103" questionnumber="1" qlbl="1" scorecardid="722">1.</span><span id="QuestionText15103" class="QuestionText" questionnumber="1" questionid="15103"
scorecardid="722">Thinking about your Outpatient Appointment, overall, how was your experience of our service? <br> Would you please tell us why you gave this answer:</span>
</div>
<div class="responses_container">
<div class="responses_wrap">
<div class="Horizontal">
<span><input value="10851" name="qun15103_722" type="radio" id="qu15103_10851_722" qnum="1" groupid="3917" rweight="12" questionid="15103" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10851" qweight="1" scid="722" isnaresponse="false" sectionid="2471"><label for="qu15103_10851_722"
class="responseLabel SingleSelect default ResponseResolved" questionid="15103" responseid="10851" style="height: 110px;">Very good</label></span>
</div>
<div class="Horizontal">
<span><input value="10852" name="qun15103_722" type="radio" id="qu15103_10852_722" qnum="1" groupid="3917" rweight="9" questionid="15103" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10852" qweight="1" scid="722" isnaresponse="false" sectionid="2471"><label for="qu15103_10852_722"
class="responseLabel SingleSelect default ResponseResolved" questionid="15103" responseid="10852" style="height: 110px;">Good</label></span>
</div>
<div class="Horizontal">
<span><input value="10853" name="qun15103_722" type="radio" id="qu15103_10853_722" qnum="1" groupid="3917" rweight="6" questionid="15103" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10853" qweight="1" scid="722" isnaresponse="false" sectionid="2471"><label for="qu15103_10853_722"
class="responseLabel SingleSelect default ResponseResolved" questionid="15103" responseid="10853" style="height: 110px;">Neither good nor poor</label></span>
</div>
<div class="Horizontal">
<span><input value="10854" name="qun15103_722" type="radio" id="qu15103_10854_722" qnum="1" groupid="3917" rweight="3" questionid="15103" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10854" qweight="1" scid="722" isnaresponse="false" sectionid="2471"><label for="qu15103_10854_722"
class="responseLabel SingleSelect default ResponseResolved" questionid="15103" responseid="10854" style="height: 110px;">Poor</label></span>
</div>
<div class="Horizontal">
<span><input value="10855" name="qun15103_722" type="radio" id="qu15103_10855_722" qnum="1" groupid="3917" rweight="0" questionid="15103" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10855" qweight="1" scid="722" isnaresponse="false" sectionid="2471"><label for="qu15103_10855_722"
class="responseLabel SingleSelect default ResponseResolved" questionid="15103" responseid="10855" style="height: 110px;">Very poor</label></span>
</div>
<div class="Horizontal">
<span><input value="2371" name="qun15103_722" type="radio" id="qu15103_2371_722" qnum="1" groupid="3917" rweight="0" questionid="15103" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="2371" qweight="1" scid="722" isnaresponse="true" sectionid="2471"><label for="qu15103_2371_722"
class="responseLabel SingleSelect default ResponseResolved" questionid="15103" responseid="2371" style="height: 110px;">Don't know</label></span>
</div><textarea name="qc15103" rows="2" cols="20" id="qc15103" class="QuestionComment standardQuestionComment" scorecardid="722" questionid="15103" textparentid="QuestionText15103" defaulttext="Please enter your comments here..."
onblur="radio('QuestionCommentBlur').broadcast(this);" onfocus="radio('QuestionCommentFocus').broadcast(this);" groupid="3917" aria-describedby="QuestionText15103"
commentonly="False">Please enter your comments here...</textarea>
</div>
</div>
<div class="NextAndPreviousButtonsHolder ">
<div id="PreviousQuestion" class="ActionButton Previous" onclick="MoveToPreviousQuestion(15103);">Previous </div>
<div id="NextQuestion" class="ActionButton Next" onclick="MoveToNextQuestion(15103, 1, 722, true)">Next </div>
</div>
</div>
<div id="Question15104" class="Question" qnum="2" responserequired="True" scorecardid="722" questionid="15104" sectionid="2471" responsetype="999" qstype="1" groupid="1" maxvalue="0" questiontype="3">
<div class="QuestionTextHolder Comment">
<span id="QuestionTextNo15104" class="QuestionTextNo" questionid="15104" questionnumber="2" qlbl="2" scorecardid="722">2.</span><span id="QuestionText15104" class="QuestionText" questionnumber="2" questionid="15104"
scorecardid="722">Please tell us about anything we could have done to improve your experience:</span>
</div>
<div class="responses_container">
<div class="responses_wrap"><textarea name="qc15104" rows="2" cols="20" id="qc15104" class="QuestionComment standardQuestionComment" scorecardid="722" questionid="15104" textparentid="QuestionText15104"
defaulttext="Please enter your comments here..." onblur="radio('QuestionCommentBlur').broadcast(this);" onfocus="radio('QuestionCommentFocus').broadcast(this);" groupid="1" aria-describedby="QuestionText15104"
commentonly="True">Please enter your comments here...</textarea></div>
</div>
<div class="NextAndPreviousButtonsHolder ">
<div id="PreviousQuestion" class="ActionButton Previous" onclick="MoveToPreviousQuestion(15104);">Previous </div>
<div id="NextQuestion" class="ActionButton Next" onclick="MoveToNextQuestion(15104, 2, 722, true)">Next </div>
</div>
</div>
<div id="Question15105" class="Question" qnum="3" responserequired="True" scorecardid="722" questionid="15105" sectionid="2471" responsetype="999" qstype="1" groupid="1" maxvalue="0" questiontype="3">
<div class="QuestionTextHolder Comment">
<span id="QuestionTextNo15105" class="QuestionTextNo" questionid="15105" questionnumber="3" qlbl="3" scorecardid="722">3.</span><span id="QuestionText15105" class="QuestionText" questionnumber="3" questionid="15105"
scorecardid="722">Would you like to thank someone for providing excellent care to you? If so, please give their name and job role and describe what the person (s) did that was excellent.</span>
</div>
<div class="responses_container">
<div class="responses_wrap"><textarea name="qc15105" rows="2" cols="20" id="qc15105" class="QuestionComment standardQuestionComment" scorecardid="722" questionid="15105" textparentid="QuestionText15105"
defaulttext="Please enter your comments here..." onblur="radio('QuestionCommentBlur').broadcast(this);" onfocus="radio('QuestionCommentFocus').broadcast(this);" groupid="1" aria-describedby="QuestionText15105"
commentonly="True">Please enter your comments here...</textarea></div>
</div>
<div class="NextAndPreviousButtonsHolder ">
<div id="PreviousQuestion" class="ActionButton Previous" onclick="MoveToPreviousQuestion(15105);">Previous </div>
<div id="NextQuestion" class="ActionButton Next" onclick="MoveToNextQuestion(15105, 3, 722, true)">Next </div>
</div>
</div>
<div id="Question15106" class="Question" qnum="4" responserequired="True" scorecardid="722" questionid="15106" sectionid="2471" responsetype="999" qstype="1" groupid="1" maxvalue="0" questiontype="3">
<div class="QuestionTextHolder Comment">
<span id="QuestionTextNo15106" class="QuestionTextNo" questionid="15106" questionnumber="4" qlbl="4" scorecardid="722">4.</span><span id="QuestionText15106" class="QuestionText" questionnumber="4" questionid="15106"
scorecardid="722">Occasionally, we like to find out more about how people experience our services, including what went well and what we can do to improve. If you would be happy for someone to contact you about your experience of
our services, please leave your name and contact details (phone or email address) in the space provided:</span>
</div>
<div class="responses_container">
<div class="responses_wrap"><textarea name="qc15106" rows="2" cols="20" id="qc15106" class="QuestionComment standardQuestionComment" scorecardid="722" questionid="15106" textparentid="QuestionText15106"
defaulttext="Please enter your comments here..." onblur="radio('QuestionCommentBlur').broadcast(this);" onfocus="radio('QuestionCommentFocus').broadcast(this);" groupid="1" aria-describedby="QuestionText15106"
commentonly="True">Please enter your comments here...</textarea></div>
</div>
<div class="NextAndPreviousButtonsHolder ">
<div id="PreviousQuestion" class="ActionButton Previous" onclick="MoveToPreviousQuestion(15106);">Previous </div>
<div id="NextQuestion" class="ActionButton Next" onclick="MoveToNextQuestion(15106, 4, 722, true)">Next </div>
</div>
</div>
</div>
</div>
<div id="section2472" class="Section" questioncount="4">
<div id="SectionText2472" class="SectionText" role="heading" tabindex="-1"> A little bit about you<span id="SectionCollapse2472" class="SectionCollapseExpand" sectionid="2472" aria-hidden="true">â–²</span>
</div>
<div id="SectionQuestion2472" class="SectionQuestions">
<div id="Question15107" class="Question" qnum="5" responserequired="True" scorecardid="722" questionid="15107" sectionid="2472" responsetype="1" qstype="1" groupid="3914" maxvalue="0" questiontype="1">
<div class="QuestionTextHolder SingleSelect">
<span id="QuestionTextNo15107" class="QuestionTextNo" questionid="15107" questionnumber="5" qlbl="5" scorecardid="722">5.</span><span id="QuestionText15107" class="QuestionText" questionnumber="5" questionid="15107"
scorecardid="722">Are you:</span>
</div>
<div class="responses_container">
<div class="responses_wrap">
<div class="Horizontal">
<span><input value="10831" name="qun15107_722" type="radio" id="qu15107_10831_722" qnum="5" groupid="3914" rweight="0" questionid="15107" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10831" qweight="0" scid="722" isnaresponse="true" sectionid="2472"><label for="qu15107_10831_722"
class="responseLabel SingleSelect default" questionid="15107" responseid="10831">Male</label></span>
</div>
<div class="Horizontal">
<span><input value="10832" name="qun15107_722" type="radio" id="qu15107_10832_722" qnum="5" groupid="3914" rweight="0" questionid="15107" class="responseselect default"
onclick="radio('ResponseSelected').broadcast(this);radio('hidePopupQuestionDiv').broadcast();" responseid="10832" qweight="0" scid="722" isnaresponse="true" sectionid="2472"><label for="qu15107_10832_722"
class="responseLabel SingleSelect default" questionid="15107" responseid="10832">Female</label></span>
</div>
<div class="Horizontal">
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</div>
</div>
</div>
<div class="Question Hidden" responserequired="False" responsetype="15">
<div class="QuestionTextHolder Comment">
<span id="span3" class="QuestionText">Phone Numbers</span>
</div>
<div class="responses_container">
<div class="responses_wrap">
<div id="PhoneNumber_AddContact">
<input name="ctl00$PhoneNumberQuestionAddContact" type="text" id="PhoneNumberQuestionAddContact" class="inputTextBoxSCCompletion PhoneNumber" validationignorewhitespace="true" validation="^$|^(?=\d{10,11}$)(0([1-6]|[8-9]))\d"
validationerrormsg="Please enter a valid landline number. This cannot start "07" and must be 10-11 digits long"> (landline) <br>
<input name="ctl00$MobilePhoneNumberQuestionAddContact" type="text" id="MobilePhoneNumberQuestionAddContact" class="inputTextBoxSCCompletion PhoneNumber" validationignorewhitespace="true" validation="^$|(^07[\d]{9}$)"
validationerrormsg="Please enter a valid mobile number. This must start as "07" and be 11 digits long"> (mobile)
</div>
</div>
</div>
</div>
<div class="Question Hidden" responserequired="False" responsetype="12">
<div class="QuestionTextHolder Comment">
<span id="Span4" class="QuestionText">Email Address</span>
</div>
<div class="responses_container">
<div class="responses_wrap">
<input name="ctl00$EmailQuestionAddContact" type="text" id="EmailQuestionAddContact" defaultvalue="" onfocus="ToggleWaterMark(this, true);" onblur="ToggleWaterMark(this);" class="WaterMark inputTextBoxSCCompletion"
validation="^[a-zA-Z0-9.!#$%&’*+/=?^_`{|}~-]+@[a-zA-Z0-9-]+(?:\.[a-zA-Z0-9-]+){1,4}$" validationerrormsg="The email address entered is not in the correct format. Please check and re-enter.">
</div>
</div>
</div>
<div class="Question Hidden" responserequired="False" responsetype="18">
<div class="QuestionTextHolder Comment">
<span id="span5" class="QuestionText">Comments about additional contact</span>
</div>
<div class="responses_container">
<div class="responses_wrap">
<textarea rows="5" cols="20" id="qcAddContact" class="QuestionComment CommentArea" commentonly="True"></textarea>
</div>
</div>
</div>
</div>
</div>
<!-- completion page based data compatibility -->
<input type="hidden" name="ctl00$cpid" id="cpid" value="288">
<input type="hidden" name="ctl00$ctl00_cpid" id="ctl00_cpid" value="288">
<input type="hidden" name="ctl00$ctl00_did" id="ctl00_did">
<input type="hidden" name="ctl00$ctl00_slid" id="ctl00_slid" value="33">
<input type="hidden" name="ctl00$ctl00_authmethod" id="ctl00_authmethod" value="ajaxCall_ValidateAuthToken_completionUpdate()">
<input type="hidden" name="ctl00$ctl00_updateurl" id="ctl00_updateurl" value="https://www.oc-meridian.com/OCQ/services/CompletionPageService.asmx">
<input type="hidden" name="ctl00$noOutlet" id="noOutlet">
<input type="hidden" name="ctl00$token" id="token">
<!--identity selection-->
<input type="hidden" name="ctl00$identifier" id="identifier">
<input type="hidden" id="rooturl" value="https://www.oc-meridian.com/OCQ/">
<input type="hidden" id="pollurl" value="https://www.oc-meridian.com/OCQ/services/CompletionPageService.asmx">
<input name="ctl00$UserID" type="hidden" id="UserID" value="0">
<input name="ctl00$CommentConsentOptIn" type="hidden" id="CommentConsentOptIn">
<input name="ctl00$languageID" type="hidden" id="languageID" value="0">
<input name="ctl00$allowFutureSubmissionDate" type="hidden" id="allowFutureSubmissionDate" value="0">
<script type="text/javascript">
//<![CDATA[
TranslatedData = {
"cloned": null,
"ID": 3,
"OnlineMessage": "Online",
"OfflineMessage": "Offline",
"EmailButtonText": "Email",
"SyncButtonText": "Sync",
"CompletionTargetUpdateText": "Targets",
"SMSButtonText": "SMS",
"PrintButtonText": "Print",
"SaveToSyncButtonText": "Save for Sync",
"OfflineErrorMessage": "You need to be online to use this function. Please check your network connection and try again.",
"DeviceDeactivatedText": "This device has been deactivated.",
"InvalidSLIDText": "The requested survey list ##ID## is invalid or has been removed.",
"ProblemSyncingText": "There has been a problem synchronising your data.",
"AutoSyncingText": "This survey list is set to automatically sychronise, if you still see items available to sync please manually do so.",
"ProcessStalledText": "The sync process has stalled, this could be due to poor connectivity or lose of connection to the internet, please press the Synchronise button to try again.",
"SynchroniseQuestionnaireTitle": "Synchronise Questionnaires",
"SynchronisingText": "Synchronising",
"ButtonSynchroniseText": "Synchronise",
"SyncNoticeText": "This page can be used to submit any questionnaires that have been completed, currently saved on this device.",
"SyncSuccessText": "Synchronisation successfull. All questionnaires have been sent to the server. Please select \u0027Home\u0027 above to continue.",
"PressSyncButtonText": "Please click on the \u0027Synchronise\u0027 button below to transmit your saved questionnaires to IQVIA Connection.",
"SynchroniseQuestionnairesCountMessage": "There are ##QuestionnaireCount## questionnaire(s) that need to be sent to the server.",
"MaxQuestionnairesSubmittedMessage": "Maximum number of offline scorecards submitted. Please use the IQVIA Connection synchronise utility to upload these scorecards. Once this operation is complete, more offline scorecards can be completed on this device",
"CountMismatchText": "The sync count does not match the actual stored data, please continue to send the questionnaire(s) and reset the count.",
"FailedHeadersText": "Failed to get the headers. Please contact Optimum.",
"AccessDeniedText": "Please contact IQVIA to discuss\\r the implementation of this functionality",
"SMSInvitationTitle": "SMS Invitation",
"SMSInviteIntroText": "This page can be used to raise an SMS message. This message will invite the recipient to complete a survey. The survey itself will be completed via a series of text messages. Please enter a mobile number below, and click \u0027Send SMS\u0027.",
"MobileNumberText": "Mobile Number",
"SurveyText": "Survey",
"PleaseSelect": "Please Select...",
"SMSOutletIntroText": "If you have been given a survey code, please enter it below. If you do not have a survey code, you can press \u0027Continue\u0027.",
"SMSCodeEntryLabelText": "Enter your code to start:",
"OutletCodeIncorrectText": "Sorry, the service code entered could not be found. Please try another code.",
"SMSSentSuccessText": "An SMS message has been sent successfully. Please select \u0027Home\u0027 or \u0027Send Another SMS\u0027",
"SMSSentErrorText": "Unfortunately the message could not be sent. Please try again.",
"SMSSavedDelayText": "SMS details saved",
"Loading": "Loading...",
"SendSMSText": "Send SMS",
"ButtonSendAnotherSMSText": "Send Another SMS",
"ButtonContinueText": "Continue",
"SMSPatientConsentText": "By providing your mobile number, you are agreeing to receive Patient Experience Survey correspondence. The Trust will use your mobile number for Patient Experience surveys only. Please tick this box only if the Patient has been informed of this and consented to their mobile number being used in this way.",
"SMSPatientConsentTextAlert": "Please make sure you have received consent from the Patient and checked the Patient consent.",
"DelayDrodownNowText": "Now",
"DelayDrodownNowAfter3Hours": "after 3 hours",
"DelayDrodownNowAfter6Hours": "after 6 hours",
"DelayDrodownNowAfter12Hours": "after 12 hours",
"DelayDrodownNowAfter24Hours": "after 24 hours",
"DelayDrodownNowAfter48Hours": "after 48 hours",
"PrivacyPolicy": "Privacy Policy",
"PleaseWait": "Please wait..",
"Downloaded": "Downloaded",
"DownloadedFiles": "files.",
"UpdatingDevice": "Updating Device",
"UpdateDetectedPleaseWait": "Update Detected, Please Wait.",
"ErrorLoadingListToUpdate": "There has been an error loading the list of items to update.",
"Reloading": "Reloading",
"UpdateError": "Update Error",
"CloseToProceed": "close to proceed",
"GettingPages": "getting pages",
"Reload": "Reload",
"PressToClose": "Press to close",
"ToCloseAndContinue": "to close And continue",
"ClickText": "click",
"UpdateStalled": "The update seems to have stalled",
"GoneOfflineDuringUpdate": "It appears you have gone offline during the update",
"Installing": "Installing",
"CacheUpdated": "Cache Updated",
"Here": "here",
"ToClose": "to close",
"ThisPageISOnlyVisibleWhenOnline": "This page is only visible when you are online",
"ModalErrorTitle": "Error",
"Online": "Online",
"Offline": "Offline",
"EnterPasswordToProceed": "Please enter the password to proceed.",
"CannotProceeedWithoutCorrectPassword": "You cannot proceed without the correct password.",
"WaitUntilOpertationCompletes": "Please wait whilst the current operation completes...",
"EnsureYouAreOnline": "Please ensure that you are online and have a strong connection before synchronising",
"SynchronisationIsTakingTooLong": "The synchronise page is taking too long to respond, please ensure you are in a strong signal area and try again",
"UnableToReachInternet": "Unable to reach the internet. Please check you have access to the internet and try again.",
"MustBeOnline": "To access this page you must be online.",
"YouMustSynchronise": "You must synchronise your existing completed questionnaires before you can go back to normal online submissions",
"SomeFilesDidNotUpdate": "Unfortunately some of the files on your device have not updated correctly during this refresh. One or more questionnaires may not operate correctly as a result. These questionnaires will be highlighted. This issue has been reported To IQVIA and a new update will be actioned shortly.",
"DeviceLastUpdated": "Device Last Updated",
"EnterPassword": "Enter the password",
"ForceAnUpdateToSLID": "Are you sure you want to force an update to this SLID? this will force it for ALL devices using it (unless we have explicitly set a device to run off its own manifest)",
"FunctionRequiresYouBeOnline": "This function requires you to be online and connected to the internet to operate.",
"RemoveThis": "Are you sure you want to remove this",
"NoBaseURL": "There is no base url stored to clear",
"NoData": "No data",
"NoInformation": "No information has been returned",
"ButtonHasBeenDisabled": "This button has been disabled",
"AccessUnavailable": "Access unavailable",
"Name": "",
"SessionID": "",
"AdminUserID": 0,
"LanguageID": 0,
"ResetObject": false,
"LogChangeReason": false,
"ChangeReason": ""
}; //]]>
</script>
</form>Text Content
Please wait.. Upload 📷 ▲ ▬ How are you recording these figures? Metric (CMs/KGs) Imperial (Feet/Inches & St/Lbs) Height (CMs): Weight (KGs): Loss in last 6 months (KGs): Height (Feet/Inches): Weight (St/Lbs): Loss last 6 months(St/Lbs): Your BMI =   Date of your Outpatient appointment: 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 01 02 03 04 05 06 07 08 09 10 11 12 2023 2024 Which Outpatient Department did you attend? Please Select... Audiology Cardiology Dept CCaSSH - Cumberland Centre CCaSSH - Kingsbridge Hospital CCaSSH - Tavistock Clinic CCaSSH - The Zone CDC CT Chemo Outpatients Chest Clinic Chestnut Unit Children and Young People OPD Chronic Pain Services Dental Specialities Dermatology OPD Derriford Hub Diabetes Centre Dietetics DVT Clinic Eden Endoscopy Unit ENT OPD Gynae OPD Healthy Bones Home Park Hub Hydrotherapy Lancaster Suite Lynher Main OPD Main OPD-Upper GI OG Neurophysiology Nuclear Medicine Ocean Suite Oncology OPD Orthopaedic OPD OT OPD Phlebotomy Community Phlebotomy Hospital Physio OPD PIU Plastic Surgery Trauma Unit Plymouth Dialysis Unit Pre-assessment Primrose Radiotherapy OPD REI OPD Renal OPD SALT Womens Day Services YourSHIP Clinic Please Select... Next Thinking about your recent visit...▲ 1.Thinking about your Outpatient Appointment, overall, how was your experience of our service? Would you please tell us why you gave this answer: Very good Good Neither good nor poor Poor Very poor Don't know Please enter your comments here... Previous Next 2.Please tell us about anything we could have done to improve your experience: Please enter your comments here... Previous Next 3.Would you like to thank someone for providing excellent care to you? If so, please give their name and job role and describe what the person (s) did that was excellent. Please enter your comments here... Previous Next 4.Occasionally, we like to find out more about how people experience our services, including what went well and what we can do to improve. If you would be happy for someone to contact you about your experience of our services, please leave your name and contact details (phone or email address) in the space provided: Please enter your comments here... Previous Next A little bit about you▲ 5.Are you: Male Female I do not wish to disclose this information Previous Next 6.What age are you: 0-15 16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ I do not wish to disclose this information Previous Next 7.Do you consider yourself to have a disability? Yes (please give details) No I do not wish to disclose this information Please enter your comments here... Previous Next 8.What is your ethnic group? White Mixed/ multiple ethnic groups Black/ African/ Caribbean/ Black British Asian/ Asian British Other ethnic group I do not wish to disclose this information Previous Next Please tick this box if you do not wish your comments to be made public ✓ Complete Survey Please use this form to add contact details. Click "Close" to save the details. Name Title Dr Lady Miss Mr Mrs Ms Professor Reverend Sir   Address Find Address Enter a Postcode Enter Address Manually Address Line 1 Address Line 2 Town County Postcode Change Address? Click here Contact Type Please Select... Next of Kin Other Relative Doctor Neighbour Social Worker Care Worker Solicitor Power of Attorney Phone Numbers  (landline)  (mobile) Email Address Comments about additional contact