Friends and Family Test We want your feedback – whether good or bad. You can provide feedback using one of our ‘We care about what you think!’ leaflets in the surgery, or by completing the form below: Friends and Family Test First Name * Last Name * Email * Enter Email Date of birth * Please use format day/month/year e.g. 12/05/1979 How likely are you to recommend the service to friends and family if they needed similar care or treatment? * Extremely Likely Likely Neither Likely or Unlikely Unlikely Extremely Unlikely Don’t Know Can you tell us why you gave that response? Do you consent to us publishing your comment anonymously on our website? * Yes No Check and Send If you are human, leave this field blank.