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The Friends and Family Test
We would like to ask you about your recent experience of our service.
What is your postcode?
Which centre did you visit?
How likely are you to recommend our service to your friends and family if they need similar care?
Neither likely or unlikely
Can you tell us why you gave that response?
What was good about your contact with the service?
What could have made your contact with the service better?
Please tick this box if you don't want your comments to be made public.
Is the patient ... ? (required)
What age is the patient?
Over 85 years old
What is the patient's ethnic group?
Mixed / Multiple ethnic groups
Asian / Asian British
Black / African / Caribbean / Black British
Other ethnic group
Are the patient's day-to-day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12 months? (include any issues / problems related to old age)
Yes, limited a lot
Yes, limited a little
Prefer not to say