THE NHS FRIENDS AND FAMILY TEST
We would like you to think about your recent experience of our service.
How likely are you to recommend our Practice to friends and family if they needed similar care or treatment?
Rows
Extremely Likely
Likely
Neither
Unlikely
Extremely Unlikely
Don't Know
Answer
Thinking about your response to this question, what is the main reason why you feel this way?
A little bit about you:
Are you?
Male
Female
N/A
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?
Yes
No
Which of the following best describes your ethnic background?
Please Select
White - British
White - Irish
White - Other
Asian/Asian British - Indian
Asian/Asian British - Pakistani
Asian/Asian British - Bangladeshi
Asian/Asian British - Chinese
Asian/Asian British - Other
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Mixed - Other
Black/Black British - Caribbean
Black/Black British - African
Black/Black British - Other
Other - Anything Else
Other - I would rather not say
Are you:
The Patient
Parent or Carer
The Patient and Parent/Carer
Thank you for completing the card and providing us with feedback to improve our services.If you DO NOT wish your anonymous comments to be shared then please tick here:
Submit
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