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* 1. We would like you to think about your recent experiences of our service. Please select option:

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* 2. Enter date & time of booking / visit / request

Date & Time

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* 3. How likely are you to recommend our GP Practice to friends and family? Please circle your answer.

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* 4. Do you have any feedback, comments or recommendations that you feel would help us to improve the service/care we provide?

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