The NHS Friends and Family Test We would like you to think about your recent experience of our service. Question Title * 1. How likely are you to recommend our GP practice to friends and family if they needed similar care or treatment? Extremely Likely Likely Neither likely or unlikely Unlikely Extremely Unlikely Don't know Question Title * 2. Thinking about your response to the previous question, what is the main reason why you feel this way? Please fill in the following information about yourself. Question Title * 3. Are you male or female? Male Female Question Title * 4. What is your age? 0 to 15 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 5. Which of the following best describes your ethnic background? White British Irish Other white background Indian Pakistani Bangladeshi Chinese Other Asian Background White and Black Caribbean White and Black African White and Asian Other Mixed Background Carribean African Other Black background Anything else I would rather not say Question Title * 6. Are you The patient The parent or carer The patient and parent/carer Thank you for completing the survey and providing us with feedback to improve our services Done