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* 1. Are you registered as a patient at Brockhurst Medical Centre?

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* 2. Roughly how often do you use Brockhurst Medical Centre?

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* 3. How do you usually travel to this surgery?

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* 4. Approximately how long does it usually take you to get to the surgery?

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* 5. If you have not used the surgery over the last year, why is this?

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* 6. Which of the available services would you say you most often use at the surgery?

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* 7. What is important to you in receiving a service from your surgery? Please rank 1 - 5 where 1 is most important and 5 least important.

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* 8. Are you

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* 9. Your age

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* 10. Your ethnic background

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* 11. Are you a carer?

Thank you for taking the time to complete this survey.
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