Friends & Family Test
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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
Could we have improved your visit today?
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Additional Questions
Can you please let us know if you are male or female?
Male
Female
How old are you?
0 - 15
16 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 - 74
75 - 84
85+
What is your ethnic background?
White
Mixed/Multiple ethnic groups
Black / African /Caribbean / Black British
Asian / Asian British
Chinese
Other ethnic group
Are your day to day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 23 months? (include any issues/problems related to old age)
Yes limited a lot
Yes limited a little
No
Prefer not to say
Did you have support to fill in this questionnaire?
Yes
No
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