Friends & Family Test - Woodhouse Hill Surgery

Overall, how was your experience of our service?

Why did you answer that?

Any other comments

Please Note: Completing this additional information is optional but helpful to the NHS in understanding the needs and experiences of individual patients.

Are you..

Male

Female

Prefer not to disclose

Prefer not to self describe

What age group are you?

Do you consider yourself to have a physical or mental health condition or disability?

Yes

No

Please give details

To which of these ethnic groups would you say you belong to?

Are you..

The Patient

The Parent or Carer

The Patient and Parent/Carer

Consent

Please tick the box if you do not wish your comments to be made public