How likely are you to recommend our GP Surgery to friends and family if they needed similar care or treatment?

Please delete as appropriate:

Extremely likely; Yes No

Likely ; Yes No

Neither likely nor unlikely; Yes No

Unlikely; Yes No

Extremely unlikely; Yes No

Don’t know Yes No

Please tell us the main reason for selecting your statement:

Name (optional)

Contact details (optional)

Are you a carer completing this on behalf of a patient? Yes No (delete as appropriate)

For further information on the NHS Friends and Family Test, please visit: www.england.nhs.uk