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The NHS Friends and Family Test - How Did We Do?
1.
Page 1
Any information you provide will be treated confidentially and used anonymously
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1.
Question 1.
Date
*
2.
Question 2.
Which of our services have you used recently?
Required
- Required.
Doctor
Nursing Team
Reception
Other
*
3.
Question 3.
We would like you to think about your recent experience of our service.
How likely are you to recommend our GP practice to friends and family if they needed similar care or treatment?
Required
- Required.
Extremely Likely
Likely
Neither Likely or Unlikely
Unlikely
Extremely Unlikely
Don't Know
4.
Question 4.
Can you tell us why you gave that response?
5.
Question 5.
Are you happy for us to anonymously publish your comments?
Yes
No
6.
Question 6.
If you would like us to contact you regarding your answers or comments, please add your contact details
7.
Question 7.
Answers to the following questions ensure we can analyse responses from a cross section of our patients - Are You?
Male
Female
8.
Question 8.
How old are you?
Under 16
16-44
45-64
65-74
75 and over
9.
Question 9.
Our Patient Participation group meets quarterly, if you are interested in joining the group and having your say on new and existing initiatives concerning the care and service we provide, please leave your name and contact details below