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* 1. Which is your GP practice?

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* 2. Would you be prepared to travel to any of the other GP practices listed above within your Primary Care Network for an appointment outside of your usual practice opening hours?

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* 3. Which of the following times would you find the most useful? (please note you can select more than one option)

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* 4. Which of the following services would you like to see available during these times?

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* 5. Which consultation methods do you prefer?  (You can pick more than one)

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* 6. What is your gender?

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* 7. What age group applies to you?

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* 8. What is your ethnic group?

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* 9. Are you a person living with a disability?

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* 10. If the appointment was not based in a local practice but at a centralised hub, how far would you be willing to travel to attend an appointment outside of your usual practice opening hours?

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