Friends and Family Test Survey

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* Please enter the Team Code for the service you attended

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* 1. Thinking about the service we provide, overall, how was your experience of our service?

Very Good

Good

Neither good nor poor

Poor

Very Poor

Don't Know

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* 2. Please can you tell us why you gave your answer?

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* 3. Did you feel that we were friendly and helpful?

Yes

Sometimes

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* 4. Did you feel that you received the correct level of information?

Yes

Sometimes

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* 5. Did you feel safe and confident in our service?

Yes

Sometimes

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* 6. Did we see you in a place that worked well for you?

Yes

Sometimes

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* 7. Did you feel that we showed you privacy, dignity and respect?

Yes

Sometimes

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* 8. Did you feel that you were involved in making decisions about the care being offered?

Yes

Sometimes

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* 9. Did you feel that we listened to you and that you were understood?

Yes

Sometimes

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* 10. Did you feel that we gave you enough time?

Yes

Sometimes

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* 11. Please tell us what we did well.

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* 12. Please tell us what we can do better.

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* What is your age range?

0 to 11 months

1 to 4 years

5 to 11 years

12 to 17 years

18 to 39 years

40 to 59 years

60 to 79 years

80 years +

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* Are you a

Patient or Service User

Other (please specify)

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* Please confirm if you allow your comments to be made public

Yes

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* Thank you for completing the survey. For questions about the NHS Friends and Family Test, please leave a comment in the box below or please email us at hnf-tr.friendsandfamily@nhs.net