Carers Patient Survey


Date of birth:

Contact number:

Are you aware that the surgery has a member of staff who has the responsibility of looking after Carers?


Is there information for Carers easily available in your surgery?


Have you been given information by the surgery about other organisations that can provide information and support to you as a Carer?


When you contact the surgery for an appointment are you offered a time that fits in with your caring role?


Are you offered an annual flu jab?


Have you been invited to any special events for Carers at the surgery?


Do you have any other comments about the support you, as a Carer, have received from the surgery?

Do you have any suggestions of how the surgery could support you further in your caring role?

Do you have any further comments you would like to share with us?