We would like you to think about your recent experience of our service & would be grateful if you would complete this short survey. Feedback from this survey will help us identify areas that may need improvement. Your opinions are very valuable.
Q1 Are you?
Male Female
Q2 How old are you?
Under 16 16 to 44 45 to 64 65 to 74 75 or over
Q3 What is your ethnic group?
White Black or Black British Asian or Asian British Mixed Chinese Other ethnic group
Q4 Which surgery do you normally attend?
Selby Carlton Riccall
Q5 How likely are you to recommend this practice to friends & family if they needed similar care or treatment?
Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don't know
Q6 If we could change one thing about your care or treatment to improve your experience what would it be?