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Your practice is one of the three that makes up Rickmansworth and Chorleywood Primary Care Network.

At present, we provide appointments on early mornings, evenings and weekends and we are seeking feedback regarding this service as we will be looking to review the service from October 2022.

We would appreciate your views so that we can provide the services that best suit the needs of our patients and would be grateful if you could complete this form anonymously.

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* 1. Which Practice are you registered with?

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* 2. Apart from GP appointments, which of the following types of appointments and services benefit you and you would like to be available in evenings and weekends? -  Please select all that apply

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* 3. Which of the following times would you be willing to make a routine appointment? -  please select all that apply.

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* 4. Which of the following days would you be willing to make a routine  appointment? -  please select all that apply

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* 5. Would you like routine telephone appointments available out of hours? - Outside of 8:00am - 6.30pm Mon-Fri

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* 6. Would you like online appointments available out of hours? Outside of 8:00am - 6.30pm Mon-Fri

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* 7. Optional Question - What Age are you?

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* 8. What gender are you?

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* 9. Optional Question - How would you describe your ethnicity?

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