Friends & Family Test
You cannot take this test at this time
How likely are you to recommend our GP Surgery to friends and family if they needed similar care or treatment?
Extremely Likely
Likely
Neither Likely nor Unlikely
Unlikely
Extremely Unlikely
Don't Know
Thinking about your response to this question, what is the main reason why you feel this way?
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Additional Questions
Are you?
Male
Female
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
If you answered yes to the question above, please give details.
Which of the following best describes your ethnic background?
White British
White Irish
Other White Background
Asian or Asian British - Indian
Asian or Asian British - Pakistani
Asian or Asian British - Bangladeshi
Asian or Asian British - Chinese
Asian or Asian British - Other Asian background
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Mixed - Other Mixed Background
Black or Black British - Caribbean
Black or Black British - African
Black or Black British - Other Black background
Other - Anything else
Other - I would rather not say
Are you?
The patient
The parent or carer
The patient and parent/carer
Thank you for completing this questionnaire and providing us with feedback to improve our services.
I do not wish my anonymous comments to be shared
My anonymous comments may be shared
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