Friends and Family Test Survey

English

Friends and Family Test Survey

Please choose the service you visited:

1. Overall, how was your experience of our service?

Very good Good Neither good nor poor Poor Very poor Don't know

Notes

2. What did you like about our service?

4000 characters remaining

Next

Can we share your comment publicly (for example, on our website or printed material such as posters)?

Yes No

Notes

3. What could have been improved?

4000 characters remaining

Next

Notes

4. Did the clinician introduce themselves to you?

Yes No

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5. Were you treated fairly?

Yes No

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6. Were you treated with dignity and respect?

Yes No

Notes

Demographics

7. Are you:

Male Female Non-binary Prefer not to say

Notes

8. How old are you?

Under 18 18 - 25 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85 + Prefer not to say

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9. Are you:

White Mixed or multiple ethnic groups Asian or Asian British Black, Black British, Caribbean or African Other ethnic group Prefer not to say

Notes