Friends and Family Test: Vaccination

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* 1. Which site did you attend for your covid vaccination ?

Telford International Centre

Robert Jones & Agnes Hunt Hospital (Oswestry)

Ludlow

Shrewsbury Bowling Centre

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* 2. Today's date

Date

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* 3. Overall, how was your experience of our service?

Very good

Good

Neither good nor poor

Poor

Very poor

Don't know

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* 4. Please can you tell us why you gave your answer and what we could do to improve?

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* 5. Are you happy for us to publish your comments anonymously?

Yes

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* 6. My age is

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* 7. Are your day-to-day activities restricted due to a health problem or disability?

Yes, limited a lot

Yes, limited a little

Prefer not to say

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* 8. What is your sex?

Male

Female

Intersex

Prefer not to say

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* 9. Is your gender identity the same as the sex you were assigned at birth?

Yes

Prefer not to say

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* 10. Which of the following options best describes your sexual orientation?

Heterosexual/straight

Lesbian

Gay

Bisexual

Other

Prefer not to say

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* 11. What is your ethnic group?

White

Mixed

Asian or Asian British

Black or Black British

Other ethnic group