Dear Patient,
Please enter your name, email address, postcode
Usual Surgery:
Q1. Are you?
What age are you?
Q2. To help us ensure our contact list is representative of our local community please indicate which of the following ethnic backgrounds you would most closely identify with?
Q3. How would you describe how often you come to the practice?
Q4. The practice would like to know what issues do you think are important at this practice, areas that you might consider include:
Access: Opening times, Waiting Times, Telephone Times
Experience: Of being a patient at this Practice
Premises: What are your thoughts on our premises?
Many thanks for your time in answering the questions on this survey.