Friends and Family TestLinkedInThis field is for validation purposes and should be left unchanged.Thinking about your GP practice*Overall, how was your experience of our service? Extremely likely Very good Good Neither good nor poor Poor Very poor Don't knowPlease can you tell us why you gave your answer?Please tell us about anything that we could have done betterA little bit about youTo help us improve our services please tell us a little more about your reasons for choosing the rating in the first question.Are you Male FemaleWhat 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? Yes NoPlease provide detailsWhich of the following best describes your ethnic background? British White Irish White Other white background British Indian British Pakistani British Bangladeshi British Chinese Other Asian background Mixed white and black Caribbean White and black African White and Asian Other mixed background British black Caribbean British black African Other black background I would rather not say Please state your ethnic groupAre you? The patient The patient's carer Not for urgent medical help* Yes, I understand this form is NOT for urgent medical helpPrivacy*Your reply will be completely anonymous but we may wish to publish the comments you have made. Please change the option below if this would NOT be ok. Yes this can be made public (it will always be anonymous) Please keep this privateConsent*By submitting your details you are consenting to providing this information for improving our services to you. The data you supply on this form will be securely stored on our website, which is hosted by a third party. We will retain this information on the website for no longer than 60 days calendar days. your contact details will not be sold or shared with a third party. I understand I can revoke this consent at anytime by contacting the practice. Our privacy policy can be viewed on this website. I agree to the privacy policy.
