Marine Avenue Medical Centre Friends & Family Test
Q1: How likely are you to recommend our GP practice to friends and family if they need similar care?
*
Please Select
Extremely Likely
Likely
Neither Likely nor Unlikely
Unlikely
Extremely Unlikely
Don’t Know
Q2: Do you wish to leave a comment regarding your response to question 1?
Tick this box if you do not wish your comments to be made public
I do not wish to make public
Q3: Who did you visit today?
Please Select
GP
Nurse
HCA
Phlebotomist
Midwife
Health Visitor
Other
Q4: Are you Male or Female?
Please Select
Male
Female
I do not wish to disclose
Q5: What is your age range?
Please Select
0-15
16-24
25-34
35-44
45-54
55-64
65-74
75-84
85+
Q6: What is your ethnic group?
Please Select
White
Mixed/Multiple ethnic groups
Asian/Asian British
Black/African/Caribbean/Black British
Other ethnic group
Submit
Should be Empty: