Friends and Family

Have your say to improve your care

We welcome patient feedback to tell us what we are doing right and what we can improve

Question Title

* 1. We would like you to think about your recent experiences of our services. How likely are you to recommend our practice to friends and family if they needed similar care or treatment?

Extremely Likely

Likely

Neither Likely or Unlikely

Unlikely

Extremely Unlikely

Don't know

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* 2. Following up to the previous question, why do you feel that way?

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* 3. Are you Male or Female

Male

Female

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* 4. What age are you

0-15

16-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

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* 5. Do you consider yourself to have a disability

Yes

Details

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* 6. Which race/ethnicity best describes you? (Please choose only one.)

White British

Black British

Black or African American

Asian or Asian British

Mixed

Other

Prefer not to say

Multiple ethnicity / Other (please specify)

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* 7. Are you

The patient

The parent or carer

The patient and parent/carer

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* 8. Thank you for completing the survey. If you DO NOT wish your anonymous comments to be shared then please tick here

DO NOT share

Can be shared