Crosland Moor Surgery
Friends and Family Test
Thank you for visiting us today.
We value your feedback and would like you to think about your experience using our services.
Q 1. How likely are you to recommend our GP Practice to friends and family if they need similar care or treatment?
Extremely Likely | Likely | Neither Likely or Unlikely | Unlikely | Extremely Unlikely | Don’t Know |
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Could you please tell us the reason for the answer you have given?
I do not wish this second response to be included in any publications or reports
Q 2. What was good about your visit today?
Your response to these questions will contribute to our Family & Friends Test score, which is shared with the public through the waiting room display, the PPT, practice newsletter and website
I do not wish this second response to be included in any publications or reports
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Equality and Diversity data (Internal Use only)
We would like to know more about you for our own analysis so we can ensure that we are helping our local population – we won’t share this information with anyone else.
Please tick the relevant boxes;
Age Group:
16 - 24 | 25 - 34 | 35 - 44 | 45 – 54 | 55 – 64 | 65 – 70 | 70+ |
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Thank you for your Feedback – please return this form to reception