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* 1. Which hospital were you visiting? Please enter the full name of the hospital and location below

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* 2. Can you confirm the date your journey took place? Please use the format dd/mm/yyyy, for example 19/03/2015

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* 3. We would like you to think about your recent experiences of our service. "Overall, how was your experience of our service?"

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* 4. Thinking about your experience with ERS Medical and the question. Please tell us why you feel this way

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* 5. Is there anything that would have made your experience better?

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