St Georges Surgery - Friends and Family Test

Friends and Family Test

Thinking about your GP practice, overall, how was your experience of our service?

Very good

Good

Neither good nor poor

Poor

Very poor

Don’t know

Comments

Please give a reason for your answer.

Tick this box if you have provided comments and would not like them to be published

A little bit about you:

Gender

What age are you?

Do you consider yourself to have a disability?

Disability details:

Which of the following best describes your ethnic background?

Who are you?

Privacy Protection

We use the information entered into this form only for the purposes of processing your Friends & Family Test submission. Information entered into this form is stored and accessed securely by designated Practice staff.

Issues raised in comments may be discussed between relevant members of the Practice. The information is used for quality monitoring purposes, in line with the expectations of the patients submitting the feedback.

The form does not require personal information. Any personal information transmitted via this form may be anonymised by the Practice when this is required to ensure compliance with General Data Protection Regulation.

All submissions are collated and sent to NHS England.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to St Georges Surgery • 62 Haslingden Road, Blackburn, Lancashire, BB2 3HS.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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