THE NHS FRIENDS & FAMILY TEST

Please select gender:*
MaleFemale

We would like you to think about your recent experience of our service. How likely are you to recommend our dental practice to friends and family if they needed similar care or treatment:*
Extremely LikelyLikelyNeither Likely or UnlikelyUnlikelyExtremely UnlikelyI Don't Know

Thinking about your respoonse to this question, what is the main reason why you feel this way?:*

Which of the following best describes your ethnic background?*
White BritishWhite IrishWhite Other BackgroundBlack CaribbeanBlack AfricanBlack Other BackgroundAsian IndianAsian PakistaniAsian BangladeshiAsian ChineseAsian Other BackgroundMixed White and Black CarribeanMixed White and Black AfricanMixed White and AsianMixed Other BackgroundAnything ElseI would rather not say

What age are you?*
0-1516-2425-3435-4445-5455-6465-7475-8485+

I am*
the patient.the parent or carer.the patient and parent/carer.

Do you consider yourself to have a disability?*
YesNo