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The first part of this survey aims to find out your experiences of using health and social care services during the COVID-19 outbreak, as well as identifying if you need further information or support at this time.

The second part of the survey asks for a few details about you to make sure that we are reaching as many parts of the local population as possible and so that we can contact you if you have requested so. It should take approximately 5 minutes to complete depending on the detail of your responses.

PART 1 - Your Experiences of Health and Social Services

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* 1. Would you like to provide feedback about using a health or care service during the Coronavirus pandemic?

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* 2. If YES, which local service would you like to tell us about today?

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* 3. Please provide name of GP practice/Ward/Denstist, for example New Hall Surgery or Cardiology (please note this is not the name of the PCN)

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* 4. How was your experience using this service?

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* 5. Please tell us more about your experience

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* 6. When did this take place? (If unsure please provide a rough estimate)

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* 7. How do you think this service or your experience could have been improved?

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* 8. Would you like us to contact you to discuss this further?

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