* 1. In the past 12 months, how many times have you seen a doctor from your practice? Please Tick Box

* 2. How quickly do you usually get seen? Please Tick Box

* 3. Satisfaction with availability of any doctor Please Tick Box

* 4. Satisfaction with availability of Practice Nurse or Healthcare Assistant Please Tick Box

* 5. Satisfaction with phone through to practice Please tick box

* 6. Satisfaction with phone through to practice Please tick box

* 7. Any other comments e.g. anything particularly good about your healthcare or anything that could be improved.

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