You can help this general practice improve its service

• This practice would like to welcome your honest feedback
• All the information provided by patients is put together in a report for the practice. Your answers will not be identifiable. Any comments you make will be included in their entirety but all attempts will be made to remove information that could identify you.
• One completed, please return this survey to reception

We would like you to think about your recent experience of our service

* 1. How likely are you to recommend our GP practice to friends and family if they needed similar care or treatment?

* 2. Are you male or female?

* 3. What age are you?

* 4. Do you consider yourself to have a disability?

* 5. Which of the following best describes your ethnic background?

* 6. Are you?

* 7. Please let us know your method of completing this survey

* 8. Thank you for completing the survey and providing us with feedback to improve our services. If you DO NOT wish your anonymous comments to be shared then please tick here

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