College Surgery Partnership

WILLAND SURGERY FEEDBACK SURVEY

This survey is now closed

Willand Surgery Feedback

Which of the following best describes you?

1. A patient who used the GP service at Willand branch surgery prior to March 2020

2. A local resident

3. A parent, relative, friend or carer of a patient registered with Willand branch surgery

If other please specify in the box below

What effect, if any, has the temporary closure of Willand branch surgery since March 2020 had on you?

1. A positive effect

2. A negative effect

3. Neither a positive or negative effect

4. Undecided

Please add further comments in the box below

If Willand branch surgery did not reopen and you had the option to register at either our main College Surgery site or Uffculme branch surgery, would you be affected by this, and if so, how?

1. Yes, it would adversely affect me

2. No, it would not adversely affect me

3. Undecided

Please add further comments in the box below

Is there anything else you think we should take into consideration when contemplating the future of Willand branch surgery?

1. Yes

2. No

3. Undecided

Please add further comments in the box below

To help us understand the needs of different people, we do ask for some additional information about you. You do not need to answer these questions but, if you do, it helps us to provide a more accurate picture of the needs of those people responding to this survey

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How old are you?

1. Under 18

2. 18-25

3. 26-35

4. 36-45

5. 46-55

6. 56-65

7. 66-75

8. 76-85

9. 85+

10. I’d prefer not to say

How would you describe your ethnicity?

1. White British

2. Asian British

3. Asian

4. Afro-Caribbean British

5. Afro-Caribbean

6. Mixed Heritage

7. Gypsy/Traveller

8. Other

9. I’d prefer not to say

How would you describe your gender?

1. Male

2. Female

3. Transgender Man

4. Transgender Woman

5. Other

6. I’d prefer not to say

How would you describe your sexual orientation

1. Heterosexual Straight

2. Gay Man

3. Gay Woman/Lesbian

4. Bisexual

5. Other

6. I’d prefer not to say

Do you have a disability?

1. No

2. Yes - tick all that apply

3. Physical Disability

4. Visual (impairment)

5. Hearing (impairment)

6. Speech

7. Learning disability

8. Cognitive disability

9. Deaf and Blind

10. Deaf

11. Blind

12. Mental Illness

13. Other

14. I’d rather not say

What is your religion or belief?

1. Christian

2. Muslim

3. Hindu

4. Jewish

5. Sikh

6. Buddhist

7. Other

8. None

9. I’d rather not say

This survey is now closed