Friends and Family Test

It is important to us to find out how our patients feel about our services. Below is the Friends and Family Test, where the first question is whether you would recommend our practice to your friends and family. Thank you for taking the time to answer these questions.

Friends & Family Test

We would like you to think about your recent experiences of our service.

How likely are you to recommend our GP practice to friends and family if they needed similar care or treatment?

Extremely likely

Likely

Neither likely nor unlikely

Unlikely

Extremely Unlikely

Don’t know

Can you tell us why you gave that response?

Do you think the practice has improved in the last 12 months?

What are we doing particularly well?

What do you feel we can improve on and how?

A little bit about you:

Are you:

Male

Female

OtherOther

What age are you?

0-15

16-24

25-34

35-44

45-54

55-64

65-74

75-84

85+

Do you consider yourself to have a disability?

No

YesYes

Which of the following best describes your ethnic background?

White

British

Irish

Other White Background

Asian or Asian British

Indian

Pakistani

Bangladeshi

Chinese

Other Asian Background

Mixed

White and Black Caribbean

White and Black African

White and Asian

Other Mixed Background

Black or Black British

Caribbean

African

Other Black Background

Other

Anything Else

I would rather not say

Are you?

The patient

The parent or carer

The patient and the parent/carer

Name (optional)

Email Address (optional)

Contact details (optional)

Date

Thank you for taking the time to complete this form and providing us with feedback to improve our services. Your support in and suggestions on improving our services are much appreciated. Thank you!

I DO NOT want my anonymous comments to be shared.

If you are human, leave this field blank.