Are you?

 
 

How old are you?

 
 
 
 
 
 
 
 
 

Who have you seen today in Surgery?

 
 
 
 

Are you satisfied with the advice/service you received today?

 
 

Have you visited the Practice in the last six months?

 
 

Do you find it easy to contact the Surgery by phone?

 
 
 

If you have difficulty contacting the surgery, at what time of day do you experience the greatest problems?

 
 
 

How do you think we could improve access to the Surgery? Any other comments/suggestions.

Are you a Carer; Do you look after a family member or friend? Have you served in the Armed Services - If YES please give your details to Reception.