East Lancashire Medical Services

Patient Survey

How likely are you to recommend our service to friends & family if they needed similar care or treatment

Extremley Likely

Likely

Neither Likely or Unlikely

Unlikely

Extremely Unlikely

Don't Know

Are there any further comments you wish to make about our services

Where you consulted by

Doctor

Nurse Practictioner

Other Health Professional

What treatment were you given today

Advice only

Face-to-Face treatment/consultation

Prescription only

Medicine from store only

Medicine from store and prescription

Referred to another service

Could you give us the first 3 characters of the postcode from where you travelled today

Ethnicity

White British

Pakistani or British Pakistani

Indian or British Indian

Other

Gender

Male

Female

Age

0-15

16-24

25-34

35-44

45-54

55-64

65-74

75-84

85+