Dr Stevens and Partners
Friends & Family Test
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
Is there anything we could do to improve your experience of the surgery?
We may publish some patient comments, anonymously, on our website. Do you consent to us publishing your comment?
Yes, you can publish it anonymously
No, I do not want it published
Please also complete the following information. Thank you.
Gender
Male
Female
Age
Under 16
16-34
35-54
55-74
75+
Ethnic origin
White
Mixed/Multiple ethnic groups
Asian/Asian British
Black/African/Caribbean/Black British
Other ethnic group