Albion Medical Practice

Friends & family test

We would like you to think about your recent experience of our service.

How likely are you to recommend our Practice to friends and family if they needed similar care or treatment?

	Extremely Likely	Likely	Neither	Unlikely	Extremely Unlikely	Don't Know
Answer

Thinking about your response to this question, what is the main reason why you feel this way?
A little bit about you:
Are you?

Male Female N/A
What Age are you?

0-15 16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+
Do you consider yourself to have a disability?

Yes No
Which of the following best describes your ethnic background?
Are you:

The Patient Parent or Carer The Patient and Parent/Carer
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