Friends and Family Test Submission

To help us improve our services please tell us a little more about your last visit to the surgery.

Your rating*
We would like you to think about your recent experiences of our service. Overall, how was your experience of our service?
- Very good
- Good
- Neither good nor poor
- Poor
- Very poor
- Don't know
Please let us know the main reason(s) for your rating.
To help us improve our services please tell us a little more about your reasons for choosing the rating in the first question.
Privacy*
Your reply will be completely anonymous but we may wish to publish the comments you have made. Please change the option below if this would NOT be ok.
- Yes this can be made public (it will always be anonymous)
- Please keep this private
Please note that no medical information or questions will be responded to. The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998.The Data Protection Act 1998 gives you the right to know what information is held about you, and sets out rules to make sure that this information is handled properly.
Phone
This field is for validation purposes and should be left unchanged.