Heathcot Medical Practice
November 2014 Friends & Family Test (copy)
This survey is now closed
How likely are you to recommend our GP Surgery to friends and family if they needed similar care or treatment?
Extremely likely
Likely
Neither likely nor unlikely
Unlikely
Extremely unlikely
Don’t know
How could we have improved your visit today?
Can you please let us know if you are male or female?
Male
Female
How old are you?
0-15
16-24
25-34
35-44
45-54
55-64
65-74
75-84
85+
What is your ethnic background?
White
Mixed/Multiple ethnic groups
Black / African / Caribbean / Black British
Asian / Asian British
Chinese
Other ethnic group
Are your day to day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12 months? (include any issues/problems related to old age)
Yes, limited a lot
Yes, limited a little
No
Prefer not to say
Did you have support to fill in this questionnaire?
Yes
No
This survey is now closed