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

 
 
 
 
 
 

If we could change one thing about your care or treatment to improve your experience, what would it be?

Did you attend today as a?

 
 
 

Please answer the following questions

Your gender?

 
 

Your age?

 
 
 
 
 
 
 
 
 

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)

 
 
 
 

Do you wish your comments to be published

 
 

Thank you for completing this questionnaire