How likely are you to recommend our practice

Extremely LikelyLikelyNeither likely or unlikelyUnlikelyExtremely UnlikelyDon't Know

We would like you to think about your recent experience of our services. How likely are you to recommend our practice to friends and family if they needed similar care or treatment?

Thinking about your response to this question, what is the main reason why you feel this way?

A little bit about you:

Are you?


What age are you?


Do you consider yourself to have a disability?



Which of the following best describes your ethnic background?
BritishIrishOther white background

Asian or Asian British
IndianPakistaniBangladeshiChineseOther Asian background

White and Black CaribbeanWhite and Black AfricanWhite and AsianOther Mixed Background

Black or Black British
CaribbeanAfricanOther white background

Anything elseI would rather not say

Are You?

The patientThe parent or carerThe patient and parent/carer